Preoperative and Postoperative Care of Patient Undergoing Eye Surgery

Introduction

Eye surgery is necessary for conditions of the eye when medication and other noninvasive treatment are ineffective.

Preoperative and postoperative care for the patient includes pain management, wound care, and maintaining a well-balanced diet.

Purposes of Eye Surgery

• To identify the etiology of eye disorders.
• To correct vision.
• To repair retinal defect and defect in eye muscles.
• To remove cataracts or cancer.
• To carry out therapeutic interventions by injecting medicine, removing blockage (stones), or inserting a stent.

Indications for eye surgery

• Patients who have undergone invasive surgical procedures for treatment of cataract, glaucoma, retinal tear or detachment, diabetic retinopathy, refractive errors of the eye.

1. Preoperative Preparation for eye surgery

• After obtaining consent from the patient, preoperative preparation should be done. This includes obtaining health history, physical examination, blood investigations and ECG in case of cardiac patient.
• Confirm the eye on which surgery is to be performed, from the patient and the case record.
• Advise the patient to take a bland diet before surgery.
• Instruct the patient to have hair wash a day before surgery.
• As per the physician’s order, inform the patient and family members regarding the use of antibiotic eye drops to be started 1 day prior to surgery four times a day in the eye which has to be operated upon.
• The eye drops should be continued through the day before surgery.
• On the day of surgery, only the antibiotic eye drops should be used; no other previously prescribed eye drops should be used on that day.

2. Preoperative Teaching for eye surgery

• Regular medications can be taken as per the physician’s order for diabetes mellitus, hypertension, and cardiovascular disease.
• Demonstrate to the patient about the use of eye drops and eye care techniques.
• After confirmation from the physician regarding the use of eyeglasses/contact lenses, instruct the client to stop their use at least a couple of weeks or even a month prior to surgery. This is because the contact lenses can change the shape of the cornea in a patient planned for any corneal surgery.
• Educate the patient to clean the face thoroughly and to remove all traces of makeup. Instruct him or her not to apply any facial cream the night before surgery.
• Instruct the patient to avoid drinking alcohol or taking any medication that will make him or her drowsy in an attempt to fend off the anxiety.
• Inform the patient and family members that someone should accompany the patient on the day of surgery, and that the patient would not be allowed to drive himself or herself home after delivery.

3. Postoperative Care for eye surgery

• Instruct the patient not to lie on the side of the affected eye after surgery.
• Provide eye care and administer eye drops as per the physician’s order.
• Educate the patient not to rub or squeeze his or her eyes for at least 1 week after surgery.
• Educate and train the patient to use eye drops as instructed.
• Ask the patient to wear sunglasses or eye shield for the first 3 days after the surgery.
• Encourage the patient to avoid makeup for 1 week.
• Educate the patient to avoid contaminated water, such as that in pools and hot tubs, for 1 week.
• Instruct the patient not to involve in sports for 1 week.
• Inform the patient that it is normal to have itching and mild discomfort for a couple of days after surgery; complete healing occurs within 8 weeks.
• In case of complications such as vision loss, persistent pain despite medication, increased redness, eyelid swelling, light flashes, or multiple new spots (floaters) in front of the eye, revisit the doctor for appropriate management.
• If the patient has cataract in both eyes, the second surgery should be scheduled only after the first eye has healed; inform regarding the follow-up care if planning for second surgery.

Special Considerations

• Address anxiety or fear of vision loss offer reassurance and emotional support.
• Discuss temporary vision changes post surgery to set realistic expectations.
• Identify and manage anticoagulants or antiplatelets (e.g., warfarin, aspirin) per surgeon’s protocol.
• Review glaucoma medications some may be continued or adjusted.
• Screen for allergies, especially to iodine or anesthetics.
• Instruct on preoperative eye hygiene (e.g., lid scrubs, antibiotic drops).
• Emphasize hand hygiene and avoidance of eye rubbing.
• Ensure informed consent is obtained and documented.
• Confirm correct eye and procedure mark per institutional protocol.
• Follow fasting guidelines if sedation or general anesthesia is planned.
• Assess for diabetes, hypertension, or respiratory issues that may affect anesthesia or healing.
• Apply eye shield or patch as ordered especially during sleep.
• For retinal surgeries (e.g., gas bubble placement), maintain specific head positioning to aid healing.
• Administer prescribed eye drops (antibiotics, steroids, NSAIDs) with proper technique.
• Space drops appropriately and avoid contamination of the bottle tip.

REFERENCES

1. Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
2. Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
3. Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
4. Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
5. Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
6. Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
7. AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
8. Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/

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