It is very important that you and your family understand exactly what to expect before and after your surgery. A member of our surgery scheduling team is available at 585-394-2020 extension 1237 to answer any of your questions.
My friend had a similar sounding retina problem but different treatment. Why is this?
There are different ways to correct similar problems. You should ask Dr. Piper to further explain this since there can be several reasons for one person requiring a different procedure than another person. Macular hole repair requires surgery in the operating room with the placement of a special gas bubble in the eye.
Do you remove my eye to do the surgery?
No. We use tiny microsurgical instruments that we place through the white part of the eye. For patients who need surgery inside the eye, these instruments cut, peel, and remove blood and scar tissue as well as perform many other functions. This is done while the surgeon looks through the dilated pupil with a special microscope. For those of you having retinal detachment surgery, this is done on the outside of the eye.
Will I be having laser?
Laser is a special type of light that helps seal leaky blood vessels as well as fix tears in the retina. It is routinely used in many retina surgeries. However, laser alone will not fix most retina problems. To remove blood, remove scar tissue, put the retina back in place, fix a macular hole and many other surgeries, additional instruments and techniques are required. If laser by itself will fix the problem, then we can usually do this quite easily in the eye clinic.
When will I be notified about the time of my surgery?
You will be called the day before surgery (typically in the morning) to notify you of your arrival time. If your surgery is scheduled on a Monday, then you will be called the Friday before your surgery date.
How soon after I arrive at the Surgical Care Center will I be having my surgery?
There are preoperative preparations that occur prior to surgery so that your surgery is done under the absolute safest conditions. This period of time can last 1-2 hours. Unscheduled emergencies prior to your surgery can occur. This can significantly delay your surgery time. We will do our best to notify you and your family if this occurs.
What can I expect once I am in the operating room?
Once you are in the operating room, no one will look familiar since everyone is required to wear masks and head covers to maintain sterility. You will receive sedation to help with relaxation. Dr. Piper will be in the room and will be performing the surgery. There will be an assistant who will help clean and sterilize the area around the eye as well as apply antibiotics and a patch at the end of surgery.
How long will my surgery last?
Retina surgery usually lasts between 45 minutes and three hours. We can be more specific with you according to what surgical procedure you are undergoing.
How will I feel after surgery?
Patients respond differently to anesthesia. It is not unusual to feel groggy after surgery. This can last from several hours to several days. However, please notify us if there is anything unusual. It is important that you call even if you think it is about something minor. Retina surgery is major eye surgery. Expect the eye to hurt after surgery after the local anesthesia wears off. Much of this can be relieved with pain medicine. We strongly encourage the use of pain medicine every 4-6 hours after surgery unless there is a contraindication. Many of you already know what works best for you. (Tylenol, Motrin, or Aleve). Some patients do have medical contraindications which do not allow the use of these. If your pain worsens or is not relieved shortly after using the pain medications, please call us. There is always an eye doctor on call after hours or you can reach us at the office during business hours.
How long will I spend in the recovery area after surgery?
This will vary depending on how you feel. This time usually lasts one to three hours depending on the duration of the surgery.
Will I get any stitches?
Yes. Unlike some eye surgeries, several very small stitches are required with retina surgery. Fortunately, these will dissolve on their own in several weeks. Following your surgery, you will probably feel like there is something in the eye. These are stitches you feel. Since both eyes move together, the best way to relieve this discomfort is to close both eyes. In fact it may be hard to keep the un-operated eye open immediately following surgery since the sensation of the sutures in the other eye cause the good eye to sympathize and try to close. This is not a problem and will stop as the stitches dissolve. While the stitches are present, there will be more tearing than you are accustomed to. This will also stop once the stitches dissolve. Occasionally, a little clear cyst can develop around a stitch on the white part (sclera) of the eye. This is okay and usually resolves as the eye heals. If it does not, we can easily remove it.
How will my eye look and feel after surgery?
Your eyelid will be swollen and droopy, and “black and blue” when we remove the patch. This is normal and will get better over the next two weeks. It is okay to apply a cool clean washcloth to the lids. Ice may be used for 20 minutes every hour for the first 48 hours. Rarely, the eyelid may not go back up 100% especially in older patients who have undergone multiple surgical procedures. If this is the case, several months after surgery, a minor procedure performed in the clinic can usually help this. The white of the eye will be very red. This is usually significantly better within two weeks. Blood may be seen on tissue paper when you wipe your eye. This is usually okay and is coming from the outside part of the eye. This should stop within several days. Watering from the eye and nose is expected, and it is a stimulus to good healing, so you do not need to be concerned about a watery discharge. If you notice a pussy discharge, please call us immediately. Sunglasses may help with your comfort following surgery, but are not mandatory.
What can I expect at my appointment on the day after surgery?
After removing the patch, your eye will be examined. Expect the vision to be very blurry at this visit. Retina surgery is very different than cataract surgery in two ways. Unlike cataracts, retina problems requiring surgery often times result in permanent visual loss. When vision improves it is gradual. In fact complete healing after retinal surgery often takes 6 months. In most cases, the visual acuity at 6 months will be the final vision. There is normal swelling of the eye after retina surgery, which initially, will limit the vision.
The most important reason for seeing you the next day is to check the eye pressure and to make sure that there are no complications that need attention. Complications are rare but can be dealt with if we can follow you closely after surgery.
Will I need to use drops?
You will be given a prescription for antibiotic eye drops. They are to be placed in the eye 4 times each day while you are awake. Use the drops until the bottle runs out. If you are using more than one type of drop it is important that you separate installation of the drops by at least 5 minutes since the eye can only hold one drop at a time. If you feel the drop has not gone in properly you may place another drop in the eye. This will not harm you since the eye only holds one drop at a time.
What will be involved with follow visits?
You will be seen on the day after surgery, the following week, and then again in 3-4 weeks.
After surgery, what things should alert me to call the eye clinic?
Anything at all that seems unusual should prompt you to call us--no matter how minor you think it may be. The symptoms that we are especially on the look out for postoperatively are:
- eye pain that is not relieved with pain medication, especially if it is associated with nausea (this can indicate high pressure in the eye)
- yellow discharge (this can indicate infection); crusting around the eyelids and increased tearing are to be expected
- new or increased floaters or flashing lights (can indicate retinal tear or detachment)
- sudden shade over vision or worsening vision
Please call immediately if you have any of the above symptoms!! When you call the eye clinic during the day at 585-394-2020, it is important to indicate that you are one of Dr. Pipers’ surgery patients to distinguish you from the many phone calls that our team receives. If you do not receive a call back shortly, please call again.
How long will I wear a patch?
Your patch will be removed on the day following surgery. Some patients prefer wearing a black “pirates” patch while the eye is healing since the blurry vision after surgery can be frustrating. This is perfectly okay.
Was my surgery successful?
Patients undergoing retina surgery usually have retina damage or disease that has caused permanent damage to the retina. Surgery is often performed to halt further visual loss or to save the eye itself. This usually involves removing blood and scar tissue within the eye. It can take up to two months to determine if the surgery has been successful. The success of your surgery will be dependent on the degree of disease prior to surgery.
Can I take a shower?
It is best not to get dirty water in the eye for several days. You can take a bath, but try to avoid getting water in your eyes.
What can I expect in regards to my vision?
Because of damage to the retina prior to surgery, the final visual outcome is impossible to predict. Visual improvement is gradual and can improve for up to six months. The use of your good eye will not harm your operated eye. However, you may feel a strain since you may not be used to using just one eye.
Will glasses improve my vision after surgery?
Glasses may or may not help with vision after surgery. The retina is very similar to the film in a camera. It has to be healthy to get a clear picture. In a camera with damaged film, having a more powerful lens on the front of the camera may not result in a clear picture. However, several months after surgery, it is recommended that you get checked for a glasses prescription, since it may further improve your final vision.
When can I go swimming after my surgery?
It is recommended that you wait two weeks to go swimming.
What are my limitations?
Some patients will have to position themselves in certain directions because of a special gas bubble placed inside the eye. Your activities will depend on the type of positioning that you must do. For example, if you have to position on your left side in bed, you may watch television as long as you can maintain this position. This will be discussed with you.
If you do not have a position requirements, then you may read, do light housework, ascend or descend stairs, watch television, etc. It is best to avoid dirty environments to help prevent infection. Car trips are okay as long as you are not required to do special positioning. Avoid lifting heavy objects.
When can I return to work?
In most cases, I recommend taking time off from work for a week. This may be shorter or longer depending on the type of surgery. You can increase your activity gradually over the week. For those of you who must position due to placement of a gas bubble, it is very important to limit your activity so that you can position properly for 90% of the day for two weeks. This will be discussed with you.
I have had a retinal detachment. What are the odds that I will have one in my other eye?
In general, there is a 15% chance of developing a retinal detachment in your other eye. There are risk factors such as near sightedness that may increase the chances of this occurring. The most important thing is to be aware of warning signs…flashing lights, floaters, or a “shade” coming across your vision.
Who can I call if I have a question or problem?
It is very important for us to know if you are having a problem no matter how minor you think it may be. Dr. Piper can always be reached in the clinic during the day. After office hours, there is always an ophthalmologist on call for our practice. Please call the office at 585-394-2020.