Eye lid surgery - pre and post op instructions
Below is some information about how to prepare, what to expect and what you should and should not do in the first few weeks after surgery to your eye lid(s).
If you normally take any blood thinning tablets (anticoagulants) it is important to discuss these with me or one of my team before your operation. In some circumstances I might suggest stopping a blood thinning medication for a short time before your surgery after discussion with your general practitioner. It may be the case that you need to stay on your medication for important medical reasons (such as a recent stroke or heart attack) despite the fact that this will inevitably lead to more bruising following surgery than if you were not taking the medication.
Please avoid taking any herbal remedies before the operation that contain arnica or St Johns Wort which can lead to thinning of the blood and more bleeding during the operation. I might advise you to take a short course of Arnica tablets immediately after the operation for 3-4 days but this should NOT be started before the operation.
You may like to prepare some boiled cooled water to keep in your fridge ready to apply after surgery as a cold compress to sooth the eye(s) and reduce swelling. Try and get some sterile swabs from your local chemist if you can. Some of my patients have used a pack of frozen peas over their eye to reduce swelling but this needs to be applied carefully to avoid “burning” the skin and also contaminating the wound.
Arrangements on the Day of Surgery
Before your operation
I will see you immediately before your operation to check that nothing has changed since I last saw you in my clinic and to check whether you have any last minute questions and to allay any concerns before signing the consent form.
Immediately After Surgery
The nurses and I will go through the post-operative instructions. Please do ask questions if anything is unclear. One of the team will phone you the day after surgery to check if all is well and answer any questions you have. My contact details are at the bottom of this information sheet if you have any other concerns or problems.
You will need someone to drive you home – friend, family or taxi. We would suggest you do not use public transport unless you have had a very minor operation, such as removal of a chalazion.
When you remove your eye dressing, the vision may be a little blurred and smeary from the operation and the antibiotic ointment, but you should not have any problems doing your usual activities at home. If you have had a local anaesthetic and you feel well you do not need anyone else to be at home with you. If you have had a general anaesthetic or sedation you should have someone at home with you the first night after surgery .
Postoperative Ointment and eye drops
You will be given an ointment or eye cream to use after the surgery. This should be applied to the wound three times a day for up to three weeks after surgery (depending on the procedure). It can also be put in the eye by pulling down the lower eyelid and putting a line of the ointment just inside the eyelid. You may also be given some lubricant drops to use for the first three weeks following surgery if you have had an operation on your upper eye lid.
Post operative cold compresses
I may advise you to apply cold compresses to your eye(s) particularly if you have had upper eye lid surgery. You will be given instructions by the nursing team on how to apply these and given some sterile saline and swabs to get you started with. You can use boiled cooled water kept in a sterile container in the fridge. Often I suggest using these as much as once every hour or so applying them for as long as you can whilst resting at home. This can be very important for getting the best results from the surgery and I may suggest doing this for one week and sometimes longer following the surgery.
The post-operative appointment is usually one to three weeks after surgery, which will be made for you soon after the surgery .
An eye patch is sometimes placed over the eye after surgery. You can remove it the next morning unless you are given different instructions by the nurse or me. If both eyes are patched after surgery, one or both of these will be removed before you go home and you may be instructed on how to apply cold compresses to your eyes in order to reduce post operative bruising and swelling which can adversely affect the outcome of your operation.
Sleeping after the operation
Wherever possible it is best to avoid sleeping on the side on which you had the operation and best to try and sleep with your head a little higher than normal with additional pillows to help drain any excess fluid away and stop it pooling on one side leading to excess swelling.
What to Expect After Surgery
The local anaesthetic will wear off in the first 1-4 hours after surgery . At this time the eyelid can become quite painful. You can take simple painkillers such as paracetamol if you have no allergies or contraindications to these. If you are in pain after the surgery, please ask the nursing staff for painkillers.
It is very common to have bruising of the eyelid or the whole area around the eye after eyelid surgery . You may have a ‘black eye’. There also may be a scab along the suture line.
You may have a little bit of bleeding or ozzing of blood stained fluid in the hours or even first few days after surgery. You can gently dab this with a clean tissue. Occasionally there is more bleeding at about five days after surgery, particularly in people who take blood thinners such as aspirin . If there is a lot of bleeding at any time please put some firm pressure on the bleeding area with a pad of tissues and if it does not stop please phone me or attend your nearest NHS eye department – either the Norfolk and Norwich University hospital or the James Paget University eye hospital.
Infection is uncommon after eyelid surgery, although any wound can become infected. Infection will cause the eyelid to become increasingly red, swollen and tender a few days after surgery and there may be some discharge . If this occurs you should either contact me or attend your nearest NHS eye department – either the Norfolk and Norwich University hospital or the James Paget University eye hospital or your GP as you may need antibiotics.
Stitches are used in most eyelid operations. Although I use dissolvable sutures wherever possible, I tend to use a nylon suture in the upper eye lid and remove the skin stitches from the upper eye lid one to two weeks after surgery. This gives a better wound healing result in my experience.
What You Can and Cannot Do After Surgery
You can bathe and shower as normal, except that you should avoid getting the eyelids very wet. It is fine for the area to get splashed or to gently dab it with clean water and a clean flannel, but avoid soaking the area in water.
Exercise and Swimming
You can do gentle exercise from the day after surgery. I would recommend that you do not do strenuous exercise or contact sports until at least two weeks after surgery. You should not go swimming until a few days after any stitches have been removed.
You should be able to drive from the day after surgery. However, the vision can still be a little smeary from the ointment and bruising, so you should take great care, and definitely not drive if the vision is not clear.
You may be able to wear make-up from the day after the operation for a minor eye lid procedure, although I would advise you not to put make-up on or very close to the wound or stiches and no other creams or ointments should be applied to the area of the operation.
You can watch television as normal after the surgery.
Bridget’s secretary Anna Ready is on 01603 814365
Spire hospital Norwich
Old Watton Road