Dr Donaldson – Retinal Surgery Post-Op Instructions

Dr Donaldson – Retinal Surgery Post-Op Instructions

We sincerely hope that your surgical experience with us has been a good one and exceeded all of your expectations.  Retinal surgery is extremely delicate, complicated surgery, and your careful attention to post-operative care of the eye is important to help achieve our goal of attaining the best possible outcome from your surgery.

It is extremely important that you read these instructions carefully the day before your surgery and again after your surgery. If anything is unclear, or if you have any questions, please feel free to contact us.

Transport

PLEASE ARRANGE FOR SOMEONE TO DRIVE YOU HOME after your surgery.  For your safety, the hospital will not allow you to drive home alone or catch public transport, (including taxis) alone after sedation or anesthesia.  If you have a general anaesthetic, you must have an adult at home with you for the first 24 hours, however even after local anaesthesia we strongly recommend that all patients have an adult at home with them for the first 24 hours after surgery.

Post-Operative appointments

• It is strongly recommended that a family member accompany you to the first post-operative visit, on the day after your surgery.
• Even if everything seems to be going perfectly, it is important to attend your post op visits. Your surgeon can often detect potential problems early, and early treatment is usually much more effective.

Activity

• For the first 48 hours after the surgery, it is important to rest as much as possible. The best thing to do is to simply relax in bed or in a chair with both eyes closed. You can walk around the house if necessary, but be aware that your balance may be affected by having one eye closed, so move slowly to minimize the risk of a fall. After the first 48 hours, you can slowly increase your activity levels. Avoid playing with very young children without wearing eye protection, as it is easy to get an accidental poke in the eye.
• NB: While your activity is limited, it is important to avoid developing blood clots in your legs. Move your legs frequently, and squeeze your calf muscles to keep the blood flowing.

Preventing infection

• Thankfully, due to modern surgical techniques, the risk of infection is much lower than it used to be and the risk of a serious infection is much less than 1%. However if this happens, the outcome can be devastating, and result in severe loss of vision or even blindness and loss of the eye.
• The risk of infection is greatest in the first 7 days after surgery, and then declines rapidly. For the first week after surgery, please wash your hands frequently with antiseptic soap or gel, especially prior to touching anywhere near the eye. If your eye is dabbed with a tissue, a clean section of the tissue should be used each time or a new tissue should be used.

Eye protection

• Do not remove the shield / pad until you see your doctor the day after the surgery. It is very important not to rub, bump, or put any pressure on the eye.
• During the day, you should either wear a pair of glasses (sunglasses, reading glasses, distance glasses are all fine) or wear the hard plastic shield. This is not to protect the eye from light, rather to protect it from being bumped. The hard shield should be worn at night time while sleeping for the first week after the surgery.

Showering/Bathing

• It is preferable to rest for 24 hours after surgery and not undergo unnecessary activity. If you need to shower, do not get the eye wet for 24 hours after surgery. After 24 hours post-operatively, you can shower as normal. If you need to keep your head in a special position, eg face down, try to maintain this as much as possible while you are showering. A bath is OK also, but do not submerge your eye under the water.
• Do not immerse your eye in a spa or swimming pool for at least one week after surgery. Bacteria levels can be much higher in pools or spas than in water from a shower.
• If necessary, the eyelids may be very gently cleansed with clean cotton, tissues or gauze moistened in sterile or tap water. This should not be done routinely, only as necessary.

Eye Drops

• You will be started on eye drops after seeing your surgeon on the morning after the surgery.

Driving

• You must not drive or operate machinery within 24 hours of having any anesthetic or sedation.
• If you were driving before the surgery, and your vision has not changed or is improved, you can drive 48 hours after the surgery if you feel visually comfortable. Be aware that distance judgment is often changed.
• If your vision has decreased for any reason, do not drive until you discuss it with your surgeon.  If you have a gas bubble in your eye, you CANNOT legally drive until the gas bubble is gone.

Food and Drink

• For the first 24 hours after surgery, please eat small, light meals. Nausea and vomiting can adversely affect the eye, and it is important to avoid this.
• You must avoid alcohol for 24 hours after any anesthetic sedation. Thereafter, 1 glass per day is fine.
• By 24 hours after the surgery, you can gradually resume a more normal diet.
• Do not take strong painkillers eg Panadeine, on an empty stomach, as this very commonly results in nausea and vomiting
• How can I eat, drink and bathe with my head down?
  Using a straw is the best way to drink with your head down. While you are eating, simply keep your eyes looking down towards the plate.

When can I resume normal activities?

• This will depend on many factors, including your age, activity level before the surgery, the vision in your other eye, the type of surgery you had and the particular problem you had that required the surgery. Most people will require at least 1 week off work. For a retinal detachment, or problem requiring a gas bubble, some people may need up to one month off work.
• In general, activities may be safely resumed according to the following schedule:

Common clinical questions post surgery

WHAT SHOULD THE EYE FEEL LIKE AFTER SURGERY?

It is normal for the eye to feel very itchy, watery and scratchy after surgery. This should slowly get better, day by day. It is normal to feel like there is sand or a foreign body in the eye. Sometimes this is due to mild swelling, sometimes due to special stitches on the surface of the eye, and sometimes due to collections of mucus. This is normal, and subsides with time.

For the first couple of days after surgery, it is not uncommon to notice some blood in the tears, on the patch, or on your pillow on waking. This is normal, and is not vision threatening.

Rapidly increasing pain, nausea and vomiting or rapidly decreasing vision is NOT normal. Should this occur, the surgeon should be called immediately. Please do not wait until your next appointment.

WHAT IF I HAVE PAIN OR OTHER PROBLEMS?

Most patients will experience some mild discomfort or mild pain after returning home. The best thing for this is to take some Panadol, Panadeine or another non-Aspirin prescribed pain reliever. Preferably do not take aspirin or other anti-inflammatories such as Voltaren or Ibuprofen as these may slightly increase your risk of bleeding. If pain becomes severe or is associated with nausea and vomiting, call your surgeon.

NB .Do not take strong painkillers eg Panadeine, on an empty stomach, as this very commonly results in nausea and vomiting

If you notice any dramatic sudden change in your vision, please call your surgeon. It is important to contact our staff without delay if you experience any of the following:

• Pain not relieved by normal analgesics.
• Sudden dramatic change in vision including blurring, cobwebs, flashing lights, dark curtains or dark clouds.
• Prolonged nausea or vomiting.
• Injury to the eye.

MY EYE IS SWOLLEN. IS THIS NORMAL?

Eyelid swelling after retinal surgery is relatively common, especially if you are positioning with your face down. This is usually normal and slowly decreases over 2-4 weeks. If the swelling is progressively getting worse and is associated with increasingly severe pain and redness with reduced vision, call the office urgently.

MY EYE IS RED. IS THIS NORMAL?

Redness is normal after retinal surgery and gradually diminishes over time. This is similar to bruising on the skin and slowly resolves on its own.

If your eye is becoming progressively more red, and is associated with increasing pain, or nausea and vomiting, please call your surgeon.

BLOOD IN THE TEARS / ON THE PILLOW

Some patients may notice a patch of red blood on the outside of the eye, in the tears or on the pillow. This is normal after retinal surgery. Call the office though if it does not stop within a few hours or there is a large amount of ongoing bleeding.