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Date issued:  November 2020

For review: November 2022

Ref: C-414/RL/REI/Vitretectomy v2

PDF: Vitrectomy.pdf[pdf] 361KB

Going home

Have a restful afternoon/evening

When the local anaesthetic wears off you may be aware of a little discomfort, and your eye may water/and or feel gritty, especially when you blink, this is perfectly normal. It is usual to want to rub your eye accidentally after an operation, but please don’t.

Take either your usual painkillers or 1-2 paracetamol if required.  DO NOT TAKE EXTRA ASPIRIN AS PAIN RELIEF, but do continue with your usual prescribed dose as normal

If you are at all concerned about your eye or if you have severe pain, headache or nausea, please contact one of the numbers highlighted on the reverse of this leaflet.

The pad and tape are flammable so please keep away from cigarettes and naked flames

Judging distances can be difficult with one eye covered so try not to bump into anything on your operated side.

Please take great care when walking up/down steps, stairs, kerbs, in and out of cars as you will not have a depth perception, and things may not be where you think they are. Use a handrail or someone’s arm.

Also be extra careful when crossing the road

Avoid cooking or pouring hot liquids if possible. If you live alone and do have to make your own hot drinks, place the cup into the sink/bowl and then pour the boiling water into the cup.

Also ensure cups and plates are not put near the edge of the table.

Dos, Don’ts and Posturing instructions

You have just had a vitrectomy /retina operation you should treat your eye gently and follow the posturing instructions below for the best chance of successful surgical outcome.

You will be going home with a pad and shield dressing to your eye you need to wear this for the first night only. You must take the whole dressing off on the first morning following surgery, throw the padding away, but keep the plastic shield to put over your eye every night for at least the first week, to prevent rubbing of the eye during sleep.

• You will have had an  injection of one of the following GAS/OIL  injected into the back of your eye 

       SF6/ C2F6/ C3F8/ Silicon oil/ Heavy silicon oil.

• You will need to posture in one of the following positions, for up to 14 DAYS, day time only, for 50 minutes at a time.

• Face down.
• Sitting upright.
• Right cheek to pillow.      
• Left cheek to pillow.    
• Alternate left and right cheeks to pillow.
• Whilst posturing you must do ankle turns/rolls and knee extensions/bends, to prevent DVT/PE/blood clot formation.
• *After this initial 14 days has finished, please lie on either your right or left sides at night until the gas bubble has dispersed
• Do not lie on your back until this has happened.
• You are allowed a 10 (ten) minute break in every hour of posturing. This is to allow you to eat/drink/ toilet break/walk around to keep your circulation flowing and help with stiff muscles and joints/get some fresh air.
• It is advisable to have a heat/lavender pad and apply to your neck, shoulder, back muscles whilst posturing to reduce stiffness and pain.
• You will have to wear a green/yellow arm band until AFTER the gas bubble has dispersed. If you are admitted for surgery under general anaesthetic, ensure that the Anaesthetist is aware of the gas bubble in your eye
• Do not fly, swim or engage in strenuous activity whilst there is still gas in your eye.
• Do not read whilst posturing to ensure the eye is not moving around

*You will know when this has happened as looking through the gas/oil bubble will be like looking through  fog/opaque glass. This sensation will clear as the gas disperses.

YOU DO NOT WANT THE GAS/OIL BUBBLE TO MOVE TO THE FRONT OF THE EYE

Will I have any vision in that eye after surgery?

You will have little to no vision at first, in the operated eye, but this depends on several variables; how much vision you had in there before surgery, where the detachment was in the eye, and the type of gas bubble that has been placed in your eye. You should at least be able to distinguish between light and dark. This should improve gradually over the following weeks as the gas bubble begins to dissolve*

* see note on previous page.

When do I come back to the hospital?

All retina patients are asked to return to the hospital to see their consultant the following day. Before returning to the hospital you MUST take off all the dressing. Don’t be surprise at the appearance of the operated eye. The white area may be red/pink in colour and your pupil could be big as it may well still be dilated; this is all perfectly normal. You need to clean the eye (see page 8) and apply a set of drops as instructed in the drop charts.

The next day follow up is generally in the REI Pre-Assessment Area on level 3; please allow at LEAST an hour for this appointment.

This appointment is to check that the gas/oil is working to keep the retina in place and also to perform a pressure check. If the pressure inside the eye is higher than the surgeon would like you will be prescribed extra drops or tablets. You will need to go to Boots pharmacy(next to multi-storey car park), which opens after 8.30am, to collect.

In extremely rare instances patients may need to be monitored and brought to the REI Daycase Unit level 7 for the morning, where treatment will be given and then monitored.

REI Daycase Unit Post-Operative 1^st day returns

Please return to the REI Outpatients Department on Level 3 and sit on the pink chairs outside Pre-Assessment Clinic

A further check will be needed in 2 (two) to 4 (four) weeks’ time to check the progress of the operation.

What to look out for during the time when the eye is recovering?

Eye

• The eye is more painful
• Red and/or sticky eye 
• Further loss of vision
• New Shadow in your side vision
• Re-detachment of retina – similar symptoms as before surgery; floaters, flashes, shadows over vision, blurring.

Deep Vein Thrombosis DVT

• Swelling, pain, redness, warmth to touch in the calf area.
• Worsening pain on bending the foot
• Leg cramps
• Discolouration of skin

PE

• Sudden shortness of breath,
• Chest pain that worsens on deep breathing or coughing
• Feeling lightheaded, dizzy or fainting
• Rapid pulse
• Coughing up blood

If you experience any of the symptoms of a DVT/PE you must contact your GP or phone 111as soon as possible

When should I be able to drive?

You must not drive until you are cleared to do so by your consultant. This may take several weeks to few months.

If you do drive without your doctor’s advice, you may not be covered by your car insurance and if you have an accident during this time you may well be prosecuted.

Cleansing your eyelid and lashes

YOU MUST NOT WASH YOUR EYES AS YOU NORMALLY DO when washing your face for the first week after your operation. You must not get any soap, shampoo, shower gel or tap water in to the operated eye.

Your eye does not need to be washed unless it becomes crusted or sticky. The eye drops you have been given sometimes leave a little white crust on your lashes. If your eye does need cleaning please follow these instructions:

• Wash and dry your hands.
• Use only freshly boiled water that has cooled in a clean container.
• Moisten a clean folded tissue, cotton pad or gauze pad by dipping it into the water. Do not use cotton wool, cotton balls or cotton buds.
• Wipe gently across your closed eyelids from the inner corner to the outer corner of the eye and throw away the tissue or cotton pad.
• Repeat this with a clean tissue or cotton pad until the eyelid feels clean.
• Throw away any unused water and dry the container for future use.

There should be no pain when you clean your eye

Putting in drops

• Wash and dry your hands.
• Invert the bottle gently twice.
• Sit or lie comfortably with your head resting back* or to the side and your eyes looking up to the ceiling.
• Place the bottle between your thumb and middle finger (second) finger and rest your thumb nail on the bridge of your nose, with the nozzle pointing towards the eye.
• Squeeze the bottle between your thumb and second finger OR tap the bottle base with your first finger until a drop falls into your eye (this may take a moment). It may be easier to use your left hand for right eye and right hand for left eye.
• Dab any excess away from the cheek.
• Close the bottle and keep it in a cool place (some drops do need to be kept in the fridge; you will be advised on this).
• Wash your hands again.

*PUTTING YOUR HEAD BACK FOR THIS SHORT TIME WILL HAVE NO DETRIMENTAL EFFECT ON THE RETINA

Our contact details:

REI DCU phone tele: 01752 439348

(Monday to Friday, 8am to 7pm) Contact us for the first week AFTER surgery only, during opening times for any advice

REI Urgent Care phone tele: 01752 439330

(Monday to Friday, 8.30am to 6pm and Saturdays 9am to 1pm) AFTER the first week following surgery

OUT OF HOURS Please ring hospital switchboard 01752 202082. Switch board will take a message from you, they will then contact the on call ophthalmic Dr who will then ring you back.