The clinic visit
- Before your clinic visit it will be helpful for you to have a good idea of what your aims are and to be clear about the problems you want addressing. Their duration, severity and impact on you are all important factors in working out an individual treatment plan.
- Old photos can sometimes be helpful.
- It is always a good idea to bring a list of your allergies, medical conditions and medications with you and to have taken your usual medications as you would do on a normal day.
- When discussing surgery, I will take you through the risks, benefits and alternatives to treat your condition to make sure that you are totally happy with your decision. I’ll make sure you have some time to cool off before actually having your procedure.
- Some people take blood thinning agents such as aspirin (and other anti-inflammatories) and warfarin. The reasons behind using these medicines can be very varied and so recommendations about continuing and stopping these medicines will depend on the particular procedure and patient. Sometimes this may involve your GP’s advice too.
- Vitamin E supplements and other herbal treatments should be avoided for 10 days before surgery.
- On the day of surgery you will have been told if you should skip your breakfast or not. Normally you should take your tablets with a sip of water. If you are diabetic, we will advise you what to do.
- Dressings can prevent you monitoring you vision, be uncomfortable and the evidence behind their use is variable. I usually apply dressings if I feel that there is likely to be significant oozing from a wound or if an implant or skin graft has been placed.
- Antibiotic cream is very commonly prescribed after surgery usually for between 1 to 2 weeks 4 times a day. This cream is a very good lubricant for the eye as well as being an excellent antibiotic.
- Eye lubricants are often intensively recommended after ptosis surgery as the effects of the anesthetic and the surgery itself can affect the eyelid closing risking the eye drying out and becoming uncomfortable. The eyelid closure usually improves within 2 days and so I will often advise that lubricants are reduced after this period.
- Antibiotic tablets are usually recommended after procedures where there has been infection or when an implant has been placed.
- Swelling and bruising are very common after local anesthetic injections and operations. The use of cold compresses (ice packs/ frozen peas) for 48 hours after surgery as much as can be comfortably tolerated is to be encouraged.
- Bleeding- sit up, apply pressure and ice packs. If it doesn't resolve within 20 mins, contact help. After tear duct surgery hot drinks should be avoided for 2 days and you should try to sneeze through your mouth rather than your nose (sounds difficult, but it is easy to do!) for a week.
- Scarring can sometimes occur and this, unfortunately, can be unpredictable. Massage with non-perfumed moisturising cream can be very useful. Generally this should be in a direction opposite to which the scar is pulling. Ten 1 min sessions in the day will be ideal. Often I will ask you to start massage a week after routine surgery to get the very best result for you. Silicone based creams such as Kelocoat do have some evidence behind modifying scarring however they can be expensive. They remain an option if there is a significant effect from the scar.
- Skin graft shrinkage is common. Again massage can be useful. Sometimes, steroid can be injected under a graft to help stop this.
Things to look out for
- Deterioration in vision, or a sudden increase in bruising, swelling or pain can sometimes be the signs of bleeding behind the eye. You should seek immediate medical attention if this occurs. You will have been given our emergency contact number and should let us know straight away.
- Redness, swelling, warmth, sticky discharge and fever can represent infection. If this occurs you should let us know and we will arrange to see you soon and assess the situation.