Advice after your nerve block for surgery
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Really important information
Your surgeon will inform you about the method they wish you to follow in more detail. It is very important you follow their instructions as closely as possible.
It is essential that patients who have been told gas was used in the eye should follow the instructions below:
- Do not fly - Do not fly in an aeroplane while there is still gas in the eye (up to a period of 10 weeks, your surgeon will advise you). The gas bubble expands at altitude, causing very high pressure and resulting in severe pain and permanent loss of vision. It is safe to fly when all the gas has dissolved. You will be advised when this is the case.
- Do not drive - While there is still gas in the eye, although it is safe to travel as a passenger in a car or train. You will need to make appropriate transport arrangements.
Will it be painful?
The operation is not normally very painful afterwards, and mild painkillers such as paracetamol should be quite adequate. The gas bubble inside the eye exerts pressure on the macular hole and helps to seal it but only when your head - and in particular your eyes - are facing the floor, so that the retina (the back of the eye) is uppermost.
Posturing involves adopting a face / eye down position for the majority of the time for 5 to 7 days starting the evening after surgery, normally until your follow up in the outpatient clinic. Your surgeon will advise you on what they would like you to do. Different lengths of time depend on your surgeon as well as the type of gas used.
Normally patients are advised to posture face and eyes down for 50 minutes out of every 60 making sure to take 10 - 15 minutes off per hour to take some gentle exercise around the house to avoid getting too stiff, and to use the bathroom, etc.
More than 5 to 7 days posturing appears not to be necessary. It is not known for sure exactly what the optimum duration for posturing is. Some eye units do not posture patients at all. Others are much more rigorous.
The success of macular hole surgery is approximately 95% closure rate when meticulous posturing is done and approximately 85% when no posturing is done. Large macular holes are unlikely to close if no posturing is done after the surgery. Please do your best!! If you really can’t posture, then be reassured there is still some chance of success.
How do I posture?
Lean your head over a table, coffee-table, your lap, or other support using a pillow for comfort. Remember that your eyes need to look down to the ground. At night lie face down on the bed on your front, or if this is impossible then on one side with your head towards the pillow.
There are special devices available to help the posturing process, and most use some sort of a head-ring to support the head and face. However, a much cheaper and neater solution is to purchase a neck support tube, sold by many shops for air travellers. These are ring or doughnut-shaped which is ideal to support the face when doing face-down posturing after retinal surgery.
Using your eyes to read a tablet, computer or Kindle or watching a TV is ok, but may not be very practical. You may prefer to listen to the radio or audio books instead. We believe that rapid eye movement (e.g. when reading) at this early stage, is not helpful regarding macular hole closure, but no-one knows for sure.
We are afraid that normal life goes ‘on hold’ during the posturing period, but it is only for a week!
What danger signs should I look out for?
Your vision will be very blurred due to the gas, but you should be able to see movement, and colour and large shapes. Sometimes the eye seems very short-sighted and fine detail may be visible at very close range. If the vision deteriorates from this level, or if the eye becomes very red and painful, then seek urgent help as this can be a sign of infection. If there is a copious discharge from the eye, then this should be reported urgently. Minimal discharge is normal.
Post-op appointments
You should have or receive an appointment in the ‘vitreoretinal clinic’ in the week following your operation, and you may be given a further appointment 2 weeks later.
Long term
Please remember that vision recovery after macular hole repair is slow and rarely complete. Most of the recovery occurs by 1 year. Spectacles may be updated by your optometrist earlier than this, typically after 3 to 4 months.
If you have any unexpected problems after the surgery, you should contact one of the following numbers for further advice:
|
From 9am to 5pm Monday to Friday: |
0300 373 5884 |
| From 5pm to 9am and at weekends: |
0300 614 5000 and ask for the Eye Doctor on call |
Contact us
If you have any queries relating to this information, please contact the Ophthalmology service.
About this information
Service:
Ophthalmology
Reference:
QQ/041
Approval date:
5 August 2024
Review date:
1 July 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.