An illumination element such as an optical waveguide for illuminating a surgical field in a patient has a light input section, a light transmitting section, and a light output section. The light input section is optically coupled to a proximal section of the light transmitting section and inputs light into the illumination element. The light transmitting section transmits the light preferably by total internal reflection or by other transmission means. The light output section is adjacent a distal section of the light transmitting section which has a light extraction area from which the light exits with an energy density. The light extraction area comprises a bore extending at least partially inward into a distal end of the light output section. A plurality of optical structures is disposed on an inner wall of the bore. The optical structures are configured to extract light from the light output section and direct the extracted light toward the surgical field.
