OHSU

Casey Eye Institute at OHSU, Portland, Oregon

Where Healing, Teaching and Discovery Come Together


Face down recovery after retinal surgery

The retina is a layer of light-sensing cells lining the back of your eye

As light rays enter your eye, the retina converts the rays into signals, which are sent through the optic nerve to your brain where they are recognized as images. The macula is a small area in the center of the retina that allows you to see fine details clearly. Due to aging, trauma, or other eye conditions (such as myopia), a hole in the macula (macular hole) can form or the retina can be torn or pulled away from its normal position. A detached retina is a very serious problem that can cause severe vision loss unless it is treated. Repair of a detached retina or macular hole may require face down recovery.

How is a detached retina or macular hole repaired?

To repair the damaged retina, your retina specialist removes some of your eye's vitreous (the gel-like substance that fills the inside of your eye) and injects a gas bubble into your eye to take its place. This bubble holds the retina in place as it heals to the back of your eye. You may have to keep your head face down (parallel to the ground or to the side) for up to several weeks after surgery so the bubble will be in the right position. With time, the bubble disappears and is replaced with your normal eye fluid. Your retina specialist will tell you how long you must maintain positioning of your head and eye.

Why is maintaining a face down position so important?

Once inside your eye, the bubble will rise to the top and float there. Since the retina lines the back of the eye, your head must be face down (or to the specific side depending on your condition) so the bubble floats and holds the retina in place correctly. The surgery may not work unless you maintain the correct position. Lying in the wrong position, such as face up, will not help with healing of the retina and puts pressure on other areas in the eye and may cause the development of further problems, such as cataract or glaucoma.

Must I maintain a face down position at all times – even when walking?

Yes, unless your retina specialist instructs otherwise, you much maintain the face down position at all times. This includes when you are standing, eating, walking, sitting or lying in bed. When walking you should have someone walk with you to avoid injury.  Your retina specialist will modify your positioning requirements so that is it tailored to your retinal situation.If you are sitting, try using a table for support to avoid neck and back discomfort. Fold your arms or palms together on the table in front of you, and lay your head forward so it rests on your arms.If you are lying down, try lying face down with your operated side hanging over you pillow (to avoid pressure)You can buy or rent special equipment designed to make your recovery period more comfortable and convenient. These include:

  • Adjustable face down chairs
  • Tabletop face cradles
  • Face down pillows
  • Face down mirrors
The face down chairs, cradles, and pillows support your head or body so that you can read, write, sleep and eat more easily and comfortably during the recovery period. The face down mirror allows you to see people and objects around you without having to turn them upside down. You can still watch television and have face-to-face conversation with visitors. Your retina specialist can give you information regarding positioning equipment or suggest other ways to make your recovery period more comfortable.