Pre-operative Information:
Surgery Package:
As part of booking your surgery you will receive a package that contains:
- Consent form (kept with the office)
- Pre-anesthetic questionnaire
- Prescription for post-operative drops
- A scheduling page for you to write
- Your surgery date and time
- Your post operative day 1 appointment date and time
- Your second post operative appointment date and time will be provided later when they become available from the hospital by our surgical coordinator
- General information pertaining to your retina surgery
Logistics:
Surgery is performed at WRHN @ Queen’s Blvd – 911 Queen’s Blvd, Kitchener, ON N2M 1B2
You will need a driver the day of surgery to drive you home.
Anesthetic:
The majority of retina surgery is done under local sedation, meaning the eye is frozen and you receive medication through an IV so you are drowsy but not fully asleep. Select cases are performed under general anesthetic (with a breathing tube and machine assisting with breathing) at the surgeon’s or anesthesiologist’s discretion.
Duration of Surgery:
Most retinal surgeries range from 30 minutes to 2 hours with most cases being under 1 hour. Expect to be in the hospital for 4-5 hours the day of surgery between arrival and registration, pre-operative preparation, surgery, and recovery.
Prescription:
The standard prescription for Tobradex one drop, four times a day, for four weeks is included in your surgery package. You may fill this any time shortly before your surgery, the day of surgery, or the day after your surgery. You do not need the drops until the first day after surgery.
Waitlist:
Patients are placed on a surgical waitlist at the time of booking surgery. Waitlist length will vary by urgency of the medical indication. In the case of elective surgeries this may be several months. Every week several emergency
Medication Instructions:
Up until midnight before your surgery you should continue taking all medication as prescribed. This includes blood thinners unless specifically instructed to stop them by your physician.
Post-operative Appointments:
Stand post operative appointments include a one day after surgery check and a two week post surgery check. These appointments are made and provided to you at the same time your surgery time and date are provided to you. Additional and subsequent appointments will be made depending on the status of the eye and type of surgery.
Positioning Equipment:
Some patients are required to maintain face down positioning after surgery. To achieve this you may be bent over while seated, lying on your stomach, using a massage chair/table, or any method you find comfortable that maintains a horizontal position for your head.
Some patients choose to rent massage tables/chairs to assist in their recovery from companies such as https://www.retinarecovery.ca/
Day of Surgery Information:
Morning of Surgery:
The day of surgery take your usual medications (except medications for diabetes and insulin) with a sip of water.
Remember to otherwise refrain from eating or drinking any foods or liquids otherwise as this may compromise the ability to perform the surgery.
Avoid wearing any face or eye make up or applying any fragrances.
Arriving at the Hospital:
When you arrive at the hospital, please register at the 1st floor general registration desk at WRHN @ Queen’s Blvd – 911 Queen’s Blvd, Kitchener, ON N2M 1B2
Once you are registered you will be directed to the 4th floor to get changed and prepared for surgery.
Accompanying parties will be directed to the waiting area on the 4th floor
Patching and Shielding:
A patch and shield will be placed over the operative eye at the end of surgery. This patch and shield will stay on overnight and be removed at your first post-operative visit.
Leaving the Hospital:
Once your surgery is completed you will be taken to a post-operative recovery area where you can retrieve your belongings, change, and have the IV removed. Usually patients are able to leave the hospital after 30 minutes in the recovery area. An accompanying party is
After Surgery:
After surgery you may eat and drink as normal as tolerated.
You may be instructed by your surgeon to assume a specific positioning (e.g face down, on side) until you are seen the next day.
If you have not received specific positioning instructions, basic light activity this first day is okay.
Leave the patch and shield in place. You do not need to start any drops the first night. When you are seen tomorrow for your one day post-operative visit we will remove the patch and shield and give you further instructions.
Post-operative Information:
Normal Symptoms After Surgery:
Expect some discharge for the first few days (blood tinged, yellow, or watery).
Redness, itchiness, scratchiness, feeling like something is in the eye are normal and should improve each day.
Abnormal Symptoms After Surgery:
Severe eye pain
Significant decrease in vision
Please call the office if you experience these symptoms
Drops After Surgery:
For the majority of patients, the standard post-operative regimen is Tobradex one drop to the surgical eye, four times a day, for four weeks then stop. Additional drops for lowering pressure may be added by your physician depending on the pressure the first day after surgery. You should resume all other long term drops (for glaucoma, dry eye, other) immediately. If you are using 2 or more drops, wait approximately 1 minute in between drops.
Positioning:
Certain retinal surgeries require specific positioning after the surgery for 1-7 days depending on the situation. You will receive specific instructions regarding how you are to position at your post operative day 1 visit if this is applicable to you.
General Restrictions After Surgery:
The eye does not need to be covered in any way. You may cover the eye if you find it more comfortable.
Avoid rubbing the surgery eye aggressively, you may clean around the eye gently with a clean cloth.
You may shower but do not direct water directly at the eye, do not immerse the eye in water like a hot tub or a pool for 2 weeks.
Avoid contact lenses for 2 weeks.
Avoid straining (activities that require you to exert yourself beyond baseline activities) for 2 weeks.
Bending is okay.
After any full time positioning restrictions are lifted (if applicable), you may resume basic day to day activity (walking, reading, cooking, cleaning). This may be as early as immediately after surgery in some cases or up to 5-7 days in others.
Gas Bubble Restrictions:
While medical gas is in the eye there is i) no flying ii) no going to high altitudes iii) no driving. Depending on the type of gas used these restrictions will last 2 weeks to 2 months on average. Your medical gas bracelet should remain on for the duration of the gas bubble. It serves as a reminder of the restrictions and informs medical personnel where rare interactions with gaseous anesthetics may occur if undergoing other medical/dental procedures. When you no longer see the gas bubble in your vision you may remove the bracelet.
Patching and Shielding:
The patch and shield will be removed at your first post-operative visit. For the vast majority of surgeries, you do not need to keep the eye shielded once it has been removed. If you need to keep the
Pain Medication:
Regular strength Tylenol or Ibuprofen should be enough to deal with any discomfort from most retinal surgeries and is okay to take. If you had a scleral buckle it is likely to be quite painful for the first 24 hours and you may have nausea and vomiting. Gravol may be helpful for this. Icing the surgical eye in scleral buckle cases is recommended.
Vision:
Visual improvement after retinal surgery is gradual and depends on the condition and procedure you have. Generally recovery is gradual.
Return To Work:
In most cases, the patients may return to work 1-2 weeks after surgery. This may be shorter or longer depending on the type of surgery, and also the type of work you do.
(For a retinal detachment, or surgery requiring a gas bubble, some people may need up to one to two months off work)