Antibiotic-steroid ointment and/or eye drops, painkillers, and an oral antibiotic are often prescribed following the surgery. If you do not already have these, you will be given a prescription and you can pick them up at the pharmacy on your way home from the surgery center. The ointment (a BB size amount) should be applied to the wounds four times daily. It should be applied in the lower eyelid 4 times daily the day of surgery and the next day so that it gets into the eye (again, a BB size amount). Ointment should be applied in the eye just at night after that to reduce some blurriness during the day. Cold compresses should be applied to the surgical sites as much as possible for the first 48 hours following surgery to minimize post-operative swelling. I often recommend a small handful of frozen peas or corn in a small baggie. Make 4-6 baggies of the frozen peas and leave them in the freezer. Place a gauze pad or thin washcloth on the eyelids then place one baggie on top of that. Keep the wounds cool as much as possible while awake for the first 48 hours. Beginning on day 3, you may begin using warm compresses 2-5 times per day for 5-10 minutes each time to help improve circulation and healing.
Avoid heavy lifting, straining, lowering the head below the waist, or strenuous exercise for 10-14 days following surgery. Sleep with the head elevated on 1-2 extra pillows at night (if possible) or sleep in a recliner-type chair with the head elevated. Place a towel over the pillowcase to protect it in the event you have some bleeding after surgery. Bruising, swelling, and even a little bleeding or clear discharge is common after surgery, especially for the first few days. In fact, swelling and bruising often gets worse for the first two days after surgery. Blurry vision is also common due to the effects of swelling and the ointment that is often used. Any bleeding can almost always be stopped by applying direct pressure with a clean washcloth or gauze pad. Typically, 5-10 minutes of continuous pressure is all that is needed. Occasionally, if there is still bleeding, 30 minutes of continuous pressure (no peeking or checking) is required. If the wound is still bleeding after 30 minutes of continuous pressure, please call the doctor. Pain is usually mild to moderate on the first day and should resolve with the use of the prescribed pain medicine. Most patients use the pain medicine on the day of surgery and a few use it for a day or two after surgery. The cold compresses will also help to make you more comfortable. Do not take aspirin, ibuprofen (Motrin®, Advil®, etc.) or any blood thinners for one week after surgery unless otherwise directed. Tylenol (acetaminophen) may be used, but do not use it with the pain medicine I’ve prescribed because it may also contain acetaminophen.
If you experience worsening pain, decreased vision or diminished color vision, purulent discharge (pus), or if the eye seems to be moving forward or “bulging”, call the doctor right away or go to the emergency room. You may begin to shower or bathe on the day after surgery. It is all right to get the wounds wet briefly, but do not soak the wounds. Dry the surgical area with a gentle “patting” motion and avoid any rubbing. Stay home and relax/sleep as much as possible for the first two days after surgery. You may do light activities such as short walks, brief trips to the store, etc. beginning on day 3 after surgery. No make-up should be applied for 10-14 days after surgery. You will want to be sure to wear dark sunglasses, both for comfort, but also to cover the bruising and swelling that will be present.
Finally, you will be seen in the office about a week after surgery to have any permanent sutures removed and to begin tapering down any ointment or drops. Additionally, you will be instructed to begin/continue using artificial tears and warm compresses. A second visit usually occurs about 6 weeks after surgery to be sure everything is healing as expected. If you have any questions or would like to see the doctor at any other time, please just give us a call at (208)939-2939.