Post operative Eye Care – Vitrectomy Surgery

What will my eye feel like following surgery?

Following your Vitrectomy surgery your eye will feel a little puffy, due to the anaesthetic. Over the weekend, the eye should become increasingly comfortable and stop feeling scratchy.  It is normal to have some discharge and stickiness the day after surgery – this can be wiped with some cotton wool dipped in cooled boiled water.

What about posturing?

These are based on individual cases and depend on the location of your macular hole or retinal detachment. Often your surgeon will discuss positioning requirements prior to surgery to allow time to obtain equipment if necessary.  However, sometime exact positioning requirements are not known until the time of surgery.  If this is the case ask the nurse or surgical coordinator about equipment suppliers after surgery.

The vision will be blurred. Depending on the reason for the surgery your vision may remain blurred for 4-6 weeks. Your vision will clear as the gas in your eye dissipates.

You may notice a ‘purple disc’ floating around – this is normal. You may then see a fluid level in the eye and then this will drop down over a few days. You will then see a large bubble at the bottom of your vision. This can appear red or black. The bubble often breaks up in to 2-3 bubbles.

As the bubble disappears, your vision should improve.

Please note that if you have a macular hole or a epiretinal membrane it may be several months before the eye achieves its best vision.

Will the eye hurt following surgery?

Generally eyes are comfortable if a little scratchy following surgery. If the eye becomes uncomfortable try regular paracetamol for 24 hours.

If the eye becomes increasingly painful, with a reduction in vision, this could be a sign of infection and should be reported immediately.

How should I protect my eye following surgery?

Do:

   1.  Take your drops.

   2.  Wear your shield at night for five nights this will stop you rubbing the eye.

   3.  If you need an anaesthetic do let the anaesthetist know you have a gas bubble in your eye.

Don’t:

  1. Get the eye wet, or rub the eye.  Don’t wash your hair for one week.
  2. Drive or lift heavy weights, or strenuous exercise for 2 weeks.
  3. Flying – okay to fly after 6 weeks (gas).  Oil – can fly on the same day.

What Drops will I be given?

Tobradex – This is a steroid and antibiotic mix. It is generally prescribed four times a day for two weeks and then a further twice a day for two weeks.

Nevanac – This is a neurofen like drug for the eye. Take it twice a day for one month post surgery

Cosopt – This controls pressure rise – start it 3 days post surgery and take it twice a day for one month

When will I be seen post surgery?

Normally patients will be seen for a 24 hour post-op visit and one week and one month following surgery.

How do I take Eye Drops?

Although millions of people put in drops every day, doing it accurately can be difficult. Especially if you have poor vision from one eye – e.g. following eye surgery. You may find it helpful to ask a spouse or friend to administer the eye drops.

Do I need to wash my hands?

Hand hygiene is vital in taking drops: You must be sure to wash them thoroughly, ideally with an anti-bacterial hand wash, clean them for around 2 minutes at least.

What is the best place to take my drops?

Find a comfortable chair, which can give your head some support. Open the bottle, turn it upside down and shake it gently to get a drop to the mouth of the bottle.

How do I give the drops comfortably?

Tip you head up and look at the ceiling. Rest one hand on your lower face and gently pull down on the lower lid. With the other squeeze the drop on to the lower lid. With practice you will get only one drop in the eye. If more go in don’t worry, as they will soon be washed out.

What shall I do after taking the drop?

After taking the drop, press on the lower eyelid below the nose, to reduce tear flow to the nose. Replace the top and if necessary place the bottle in the fridge.

How do I give eye drops?

For many having eye drops given is very useful. To give eye drops first wash your hands as above. Then take the bottle, remove the top and shake vertically to get the drop to the mouth of the bottle.

With one hand hold down the lower lid of the eye, taking care not to touch the eye with the bottle gently drop the treatment onto the lower lid. Be careful not to touch the cornea or clear part of the eye.

Richard Nelson

Consultant Ophthalmic Surgeon