Patient Instructions: Retinal Surgery

If you have undergone Retinal Surgery, please carefully read the following instructions:

Before Your Surgery

Schedule Appointment for Medical Clearance with your Primary Care Physician. You must schedule an appointment with your primary care physician for pre-surgical evaluation and clearance particularly if you have any medical problems. If your cardiologist needs to be involved in the clearance, we will need a written report of their findings prior to surgery. If you do not have a primary care physician we can refer you to a physician of our choice. If you need assistance in obtaining this clearance, our surgical coordinator can assist you. Please have your primary care physician fax the results of this evaluation to the attention of our surgery scheduler at 310-944-3393 so that the retina specialist, in charge of your care, can review the results and include the report in your medical record.

The Day Before Surgery

You will be called the evening before surgery to confirm the time you are to report to the ambulatory surgery unit (ASU) or Hospital. If you do not hear from us by late afternoon or early evening, please call The Surgery Center at 310 -784-2710 or Good Samaritan Hospital at 213-977-2121 (Admissions) to confirm your surgery and obtain information regarding your arrival time. If your physical condition changes (you develop a cold, fever, etc.), call your physician (see phone numbers above). Eat a light dinner that will not upset your stomach.

Do not eat or drink anything after midnight.

The Day Of Surgery

No Insulin on the day of surgery. Take high blood pressure medication with a small amount of water on the day of surgery. Bring your insurance information to the hospital or Surgery Center as well as a list of your medications and whatever personal items you might need. If you take insulin, bring it along. Upon arrival at the hospital, go to the admitting desk. While you may rinse your mouth and brush your teeth, you should not drink coffee, juice, water, gum or hard candy. During sedation or general anesthesia, stomach contents may result in serious complications. Eating prior to surgery may result in the cancellation of your surgery.

  • Do not drink alcoholic beverages within 24 hours of your operation.
  • You may bathe or shower on the morning of surgery.
  • You should not eat or drink on the day of surgery.
  • A responsible adult must accompany you to the hospital and escort you to the ASU. It will be unsafe for you to drive a car home. If such a person is not with you when you arrive, your operation will be canceled.
  • Be sure to confirm with your doctor or our surgical coordinator the location of your surgery; determine whether it will take place in the South Bay Surgery Center or Good Samaritan Hospital. Please see directions for ASC, and note that there is free parking.
  • If your surgery is in the hospital, you will park in the garage. You will be charged $6.00 per vehicle, per patient.
  • Do not wear makeup, perfume, hairpins, combs or clasps.
  • All removable dentures or bridges, contact lenses and glasses must be removed before going to the Operating Room.
  • Do not wear any jewelry (including watches, medals, rings, earrings, etc.) to the hospital.
  • Wear low-heeled shoes and loose, comfortable clothing.
  • Because of the limited size of the ASU, there should only be one adult accompanying you on the day of surgery. Children are not permitted in the ASU unless they are undergoing surgery.

Following surgery, you will be taken to a recovery area where you will be watched carefully until it is determined that you are ready to be discharged.

  1. You will be assisted in dressing and checked before discharge.
  2. You will be given post op instructions and medications.
  3. If you have any problems following your surgery, please contact our office and your doctor will be paged immediately.

Postoperative Instructions

Since vitrectomy is often performed along with other procedures, postoperative instructions may vary.

1. Begin using your “White cap” antibiotic drops ZYLET the day after your surgery is performed. This drop minimizes inflammation and the risk of infection following retina surgery. Apply one drop in the operated eye, 3 times per day, until further notice.

2. Begin using your “Purple Cap” pressure drops ALPHAGAN the day after your surgery is performed. This drop is used to control the eye pressure. After retina surgery the pressure in the eye may increase and the elevated pressure may lead to vision loss. This drop works by decreasing the pressure in the eye. Apply one drop in the operated eye 3 times per day until further notice.

3. Begin using your “Red Cap” friendly drops HOM-ATROPINE. This drop minimizes pain caused by swelling and inflammation, following retina surgery. Atropine paralyzes the iris by dilating the pupil, which helps avoid discomfort following your retina surgery. The dilation also causes vision to blur for up to 2 weeks. Please be patient; the pupil will return to normal and your vision will slowly improve over time. Apply one drop in the operated eye 2 times per day until further notice. There are times in which this drop is not to be used after surgery. Our physicians and/or surgery schedulers will let you know ahead of time.

An occurrence of rapidly increasing pain is not normal. If this should happen, please contact our office at (310) 944-9393 immediately. Our doctors are available 24hrs a day. During the off hours and weekends, our after hours receptionists will page our doctors immediately.

FAQ: Home Rest After Surgery

Once you leave the hospital, your recovery will become primarily your responsibility. Your physician and nurse will have explained how to care for your eye at home, and given you “Discharge Instructions”. Please refer to your “Discharge Instructions” for specific care procedures. The following Q&A section, addresses the most common concerns of Retina Macula Institute patients, following retina surgery. Please call the office at 310-944-9393 if you have any additional questions or concerns.

What can I do? The first week after your surgery, it is important to take it easy; walk and move your head slowly. Pamper yourself and get a lot of rest. Avoid excessive reading or TV watching. Unless otherwise instructed, you may increase your activity after four (4) weeks but still avoid heavy lifting; that is, anything more than 20 pounds. Avoid any strenuous activity that requires straining and causes the veins in your neck stand out.

Can I exercise? No. You should avoid exercising for at least 2 weeks following your surgery. You may resume normal activities, little by little. After week 1, you may start by walking as much as a mile. You may advance to 2 miles, in the second week and can typically run by week six. This is unless your retina specialist has advised you to the contrary.

On the day of my surgery can I remove the eye patch? No. Do not remove the eye patch. Our trained team of experts will remove it the day after your surgery.

How do I use my patch and shield? You should sleep in your metal shield at night for two (2) weeks to avoid injuring or putting pressure on your eye while you sleep.

  • The hard shield will be given to you in your kit. The eye shield should be taped in place by diagonal strips of tape, which run from the forehead to the cheek, passing over the affected eye.
  • You need not wear the shield during the day unless you feel more secure with it on. Instead, you can wear your glasses to protect your eye from injury.
  • Some watery discharge and mucous secretion is to be expected, but yellow or foul smelling drainage should be reported to your doctor.

How do I use my drops? The best method for using drops is to follow the “pouch technique”. Lean your head back or lie down. Pull your lower lid down to form a pocket or “pouch”. Look up. Put one drop into the pouch, being careful not to touch the top of the bottle to the eye, eyelids or eyelashes.

  • Keep your eye closed for one full minute, following the drops. Allow at least three minutes between each drop. Always wash your hands before and after using drops.
  • Avoid contaminating the bottle tips. Bring your medications with you to the office for each visit. Continue to use your medications until your doctor instructs otherwise. Resume the use of any eye medications that you were on before surgery, unless instructed otherwise by your doctor.

What is normal postoperative discomfort? Many people experience minor postoperative discomfort. Soreness, redness, tearing, and sensitivity to light is normal and will gradually decrease as you recover.

• You may use over-the-counter non-aspirin analgesics (Tylenol, etc.) and warm compresses to relieve minor discomfort. Use prescription pain medications as instructed by your physician. An occurrence of rapidly increasing pain is not normal. If this should happen please call us immediately at 310-944-9393 and your doctor will be paged.

Can I shower and wash my hair? You may shower and wash your hair carefully the day after your surgery. Do not scrub your head vigorously. Avoid getting soap and water in your eye. Do not let the water pound on your face. If you wear a patch in the shower, remember to change it afterwards. Be especially careful getting in and out of the shower, to avoid falling or bumping your eye.

Will I have to position face down? Only if a gas bubble is placed in the eye during surgery for a macular hole and/or for a retinal detachment repair. The bubble serves as a “splint” to help hold the surgically repaired retina in place until it has had a chance to form a firm reattachment. If you have had a macular hole repair, you will be asked to take advantage of this splint-like effect by laying yourself in a face down position until the bubble clears. You will also be required to sleep in a face down position.

  • While you are recovering in a face down position, you may only get up for meals and to use the bathroom. You may stretch and move as you need but do not lie on your back. Try to maintain a head position, parallel to the floor and looking down.
  • Most patients rent a face-down positioning device such as a massage table or chair. You will be given a device rental order and should have this ready prior to your surgery.
  • The gas bubble is gradually absorbed and, in most cases, will be significantly diminished in 3 to 4 weeks. Because the gas is susceptible to expansion at high altitudes, which can be hazardous to your vision, you will not be allowed to fly until the gas bubble has absorbed. This usually takes a minimum of six (6) weeks. As the bubble decreases in size you may see the edge of the bubble as a shadow in the lower field of your vision. This is no cause for alarm.

What can I expect about my vision? You may expect a gradual improvement in your vision. Immediately after surgery, your vision may be blurry, due to the gas bubble, topical eye ointment, dilation or tearing. The retina heals slowly so you should experience a slow steady progress. Four (4) weeks after surgery, the improvement should be significant, especially if you had a gas bubble procedure. Within six (6) weeks you may be close to your final postoperative vision. However, the retina can continue to heal and vision improve for a year or more, following surgery. Do not be discouraged. Be patient and vigilant. We encourage you to evaluate your vision regularly and inform your physician if you experience any negative changes.

Can I drive? It is best to refrain from driving until your vision has improved. You may drive if the vision in your fellow eye is within the legal limits for licensing in your state. You may wish to check with your State Motor Vehicle Licensing Department for their criteria. Your automobile insurance agent may be able to advise you, as well. If you are relying on the vision of only one eye, remember your depth perception will be impaired and your field of view will not be normal.

When can I go back to work? If you have a “sit-down” type job, you may return to work around fourteen (14) days, unless otherwise instructed by your physician. If you have any doubts about your ability to resume work, discuss this with your physician. You may be entitled to up to 6 weeks off from work following your surgery. Ask your surgeon before returning to any physical activity, which requires straining or rapid movements. Do not engage in heavy labor, heavy equipment operation or yard work for at least one month.

When can I resume sexual activity? Discuss this with your retina specialist during your first post-op visit.

When am I checked after surgery? Your first post-operative appointment will be the day after surgery at one of our office locations. Subsequent visits will be scheduled during this appointment. Our surgery scheduler will make the 1st appointment prior to your surgery. At the time of your post-op visit please bring all eye drops, both new and those used pre-surgery. For your convenience we have attached a map, detailing the location of your next visit. It is very important to keep all post-operative appointments as scheduled. With any surgery there is potential for complications. The doctor can treat these problems most effectively, earlier rather than later, preventing the complications from becoming more severe. If you have any questions, please call the office and ask to speak with any of our friendly staff members. We are here to help! Just ask ☺.