When I had my vitrectomy, I had to spend three days recovering in a face-down position. Here are my survival tips.
I hope you're prepared for it. Otherwise, it can come as quite a nasty surprise after having a surgical procedure called a vitrectomy. I am speaking of face-down recovery, or face-down positioning, after retinal surgery. The thought of being face-down all day long, and—worse yet—sleeping on one's stomach, fills most patients with dread.
This type of positioning is essential for your surgical recovery after a vitrectomy, especially if you are having a macular hole repaired or your retina has detached. Your surgeon will insert a gas bubble in your eye to replace the vitreous that has been removed, and in order for this gas bubble to exert the right amount of pressure on the macula (the back of the eye), you have to be face-down. This constant pressure on the back of the eye helps the macula to bond and heal.
But it can be absolutely excruciating, boring, and stressful to spend an extended period of time this way.
Isn't there another way?
I had this same question. I thought, no way should anyone have to do this!
Well, in some rare instances, a patient may not be physically able to assume this position for a lengthy period of time due to musculoskeletal problems (osteoporosis comes to mind). It is theoretically possible that with a retinal detachment, you wouldn't have to do face-down positioning (because of the location of the tear or detachment), but the overwhelming majority of the time, you'll have to be face-down.
You will have a gas bubble in your eye following surgery, or, less frequently, silicone oil. The gas bubble will disappear completely within weeks, but the silicone oil will be there indefinitely, and will necessitate another surgical procedure to remove it.
If you’re going to have to do this face-down positioning, you need to know some good tips for surviving the ordeal. When I had my vitrectomy a few months ago, I had to spend three days in this position, so I speak from experience.
One positive thought, before I begin!
Before I list a few hints, you must know that you can use this time face-down to enhance your creativity. This is not a natural position, now is it?
Years ago, I remember reading that when a writer has a creative block, the best way to unleash new strains of thought is to spend all day lying in a hammock doing nothing! Well, you won’t be doing much during your recovery except watching TV half-heartedly or listening to music, so you might as well let your mind wander where it will.
For instance, my mind came up with a few absurd thoughts while I was face-down. I found myself wishing that I was one of those ancient Egyptians with their impossible anatomy. As an Egyptian, if I wanted to make my eye socket point down, all I would have to do is lie comfortably on my side. But then, what would I do with my feet?
- Rent vitrectomy recovery equipment. You may be able to get partial reimbursement from your health insurance on this. Check your policy for a durable medical equipment rental allowance. The vitrectomy chair is especially helpful if you want to spend time watching TV. It is cleverly designed with a mirror which enables TV viewing.
- Unless watching TV, I found the best and most comfortable position for me was putting my head down on one of those satin horseshoe-shaped pillows on top of my card table, which was just the right height. A padded card table is best, because it is easier on your elbows. If your table isn’t padded, you can easily figure out a way to make it padded.
- Make arrangements for someone to be with you all or part of the time. It goes without saying that you won’t be able to prepare meals, so you’ll need some help. You may be able to cope just fine not having anyone there while you are asleep at night. How much help you’ll need depends on how strict the face-down positioning is.
- Have an ample supply of drinking straws, especially if you like to sip on liquids throughout the day.
- For sleeping, a massage table would be very beneficial, since it has a hole where your head goes. If you can borrow one, you’ll probably sleep better.
- For that matter, hiring a massage therapist to massage your neck and shoulders would provide welcome, soothing relief for tight muscles.
- Rub-in analgesics like Ben Gay are helpful for your muscles. Long-acting patches like Tiger Balm provide longer relief.
- Stock up on books on tape from the public library, or have plenty of DVDs to watch during your recovery. Reading and web-surfing are more difficult, but they can be done, depending on the kind of positioning aids you have available.
- The tissues in your face will get puffy and swollen from being face-down. If you have a horseshoe-shaped form to put your head on, it may also come with a cold pack which you can keep in the freezer and get out from time to time. Positioning your face on the cold pack helps with the swelling.
- If you suffer from seasonal allergies, try not to schedule your surgery during times when you know you’ll have trouble. Having to be face-down will make your stuffy nose and watery eyes much more uncomfortable, and perhaps hamper your breathing.
- When your muscles ache, you can take over-the-counter pain relievers. If you’re miserable, your doctor can prescribe a muscle relaxant. That medicine will make you very drowsy and help you sleep. In fact, during the day, if you occasionally nap in your vitrectomy chair, it’s not a big deal. Just don’t sleep overnight in it.
- If you’re a man, you’ll have the easiest time sleeping face-down. If you’re a flat-chested woman, the same. In fact, if you’re such a female, for once in your life, you’ll be blessedly, blissfully grateful for such anatomy.
- If you’re prone to skin problems and acne, don’t worry too much about the pressure on your face. My forehead is a problem spot for breakouts, but I did not get any pimples following my time spent face-down. But if you’re concerned, just use lots of ice to relieve the swelling in your face.
- Have some good conversations with your spouse, kids, or temporary caregiver. Or, better yet, spend time talking on the phone with friends whom you rarely see. They won't be distracted, because eye contact won't matter.
It's worth it
As with all things, your best strategy is a positive attitude. Your face-down time will go faster than you expect. Mine was only three days, but the recovery time for this procedure may be as long as two weeks. Either way, you’ll have something to look forward to. When you go to the doctor and receive your “get out of jail card," you will be happy once again to be in the land of the upright. And you’ll know you did a good job to help your eye get well again.
This is a related article I wrote that you may find useful:
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
Question: How long do I stay face-down after a Vitrectomy?
Answer: Totally arbitrary, and it depends on your surgeon and what he recommends. When he is satisfied with the way the back of your eye looks, and the healing, he will recommend discontinuing the practice. Most people wouldn't go longer than a week or two with face-down positioning.
Ann Shockley on January 11, 2020:
I had this surgery and I could not see out if my eye for about 10 days. It seemed like I was looking underwater. I also became a little nauseous by the end of the day because of this. When the bubble finally disapted I was so relieved. By 8 weeks I was much improved, Glad I had this procedure done.
Barbara Shelor on January 09, 2019:
Im have a gas bubble put in my right eye i have a retinia tear .How long before i can return to work i am a cook at a soup kitchen and have to lift also..How long in face down positions
Desaray on August 26, 2017:
About 3-4 months ago, I started having issues with my left eye being fatigue. I wear contacts during the day and glasses at night. I just figured it was time for an overdue checkup. I wasn't in substantial pain but eventually I noticed my vision was distorted in the middle of my eye. I decided to get an eye exam. From there, the "REAL" journey began. After 2 confirmations, I was diagnosed with a macula hole. In a week's time my surgery was scheduled. I was told this type of diagnosis is common in the elderly. I am 48 yrs old!
I did alot of research and decided to rent vitrectomy supplies for my recovery. Right now I am in the face-down position for 10 days. The first night was horrible but I am determined to assist in my healing process. Phone calls, family, and friends are keeping me sane, lol. I am sleeping every 3-4 hrs. FOUR more days. I pray my recovery is successful.
Psula on August 18, 2017:
Just had a vitrectomy 3 days ago. The lying down on my stomach and head down all day is so difficult with arthritis and fibromyalgia. Thank goodness for ice packs and hot packs for lower back and shoulder pain. 4 days to go@! Then planning for the other eye! London. Ontario
Mariea M on March 06, 2017:
I'm 73. My VMT was discovered durning my Cataract evaluation in December 2016. My retina specialist said "wait and see, it may reverse its self". I chose not to have Cataract surgery at that time. Which was a wise decision as I developed a small maclura hole in my retina last week. My vitrectmoy was Friday morning to repair the hole. Although I do have a gas bubble in my retina my doctor instructed me to only keep my head in the downward position just part of each day and to sleep on either side with my head in a doward position....this is fairly easy for me as I sleep in the fetal position. So I would say each situation is different and you should do as your doctor recommends.
As my condition was not as severe as other cases my recovery will not take as long. Which should be two to three weeks. My doctor said that the recovery as to the face downward position has changed quite a bit in the past few years.
gracenotes (author) from North Texas on November 02, 2016:
I would trust my surgeon when he approves sleeping positions. I have been amazed, talking to various people with retinal surgery, that not all surgeons think alike or recommend the same things.
But it sounds like you have got plenty of time to consider your recovery, and if you do have to be face-down while wearing a C-PAP mask, you'd likely do well with a massage table, which has a cut-out for your head, and plenty of room for a mask. A vitrectomy recovery equipment company also likely has something they can recommend for sleeping, and they can rent it to you. The top of your head is what needs support, and I bet someone has equipment which will work.
I do hope you get to sleep on your side. Please come back and let me know how it all went.
gracenotes on November 02, 2016:
I would listen to your retinal surgeon on the sleeping position. I have heard of all kinds of ways to sleep, and it seems every situation is different. For instance, my brother-in-law required emergency surgery because his retina was detaching, and he was required to keep his head in a cocked (angled position) for a week, which is very different compared to facedown, which is what I did.
Having said that, I am not familiar with the placement of a C-PAP machine, but it seems to me that you could even accommodate to that with head-down sleeping. If you borrow or rent a massage table, that would have an opening that (I suspect) would easily accommodate a mask. Your forehead and the top of your head is what needs support, not your whole face.
Sounds like you've got plenty of time to plan. Let me know how it goes for you. Three days is bearable, from my own experience.
dave w. on November 01, 2016:
I have sleep apnea and have to wear a mask. I am having the macular hole surgery. The surgery is on my right eye. The surgeon said I could sleep on my left side. Is that okay with the gas bubble? My surgert is on December 13th. I was told i need to keep my head down 3 days. What do you think about my head position? Can I somehow sleep with my head down with the mast on?
betty w on August 15, 2016:
I am 67 and having my surgery today at a seattle hospital. Which is about 60 miles away. I have to have it at a hospital because I am on oxygen and have copd. They do that for a precaution. Anyway some of my concerns have been cleared up. I did not know how the gas balloon was going to get out. Thank you very much
gracenotes (author) from North Texas on February 12, 2016:
Angel and stepf,
I hope you are doing well after surgery and with your recovery!
angel on February 10, 2016:
Going into surgery now, to repair a year long detached retina, terrified to say the least, more scared about the two weeks of not moving than the actual surgery, hopefully I will sleep, a lot.
stefp on January 16, 2016:
Just had my 4th surgery. Have had air, oil and gas twice. Had to lay face down for a week. Borrowed a massage table. I found using one of the travel neck pilllows around the face opening helped. Got a box and put my Kindle on it. Watched Nextflix and Prime. Caught up on a lot of series and some new ones.
gracenotes (author) from North Texas on August 08, 2014:
Thank you Wvugirl! I hope the rest of that recovery goes well.
wvugirl2007 from Virginia on August 08, 2014:
Thank you for this hub. My husband just had his first surgery since we have been together. He had one as a child, but they could not save that eye. This is now the other eye. He is having to deal with it mostly blind. I am thrilled at the face he is able to see light and shapes at day three. His mother has tried to help through being a caregiver for the first time from four hours away and my mother has been an amazing help. Still it is very scary. Thank you for all the suggestions and I am glad to read the comments of success stories.
gracenotes (author) from North Texas on December 05, 2012:
Natalie, best of luck for your son's surgery. I cannot add anything to what I have in this hub. Thanks for coming by.
Natalie Levi Nagli on December 04, 2012:
thank you for all the information. My 11 years old son is having a surgery on December 19th. What other products can you recorded.
gracenotes (author) from North Texas on October 26, 2012:
Hello Cindy, thanks for the comments on my article. I'm really sorry you have to go through this face-down stuff, but I hope your macular hole surgery is successful, in any case.
Sleeping on my stomach is something I hope never to do again. I'm glad you were helped by my post.
Cindy on October 25, 2012:
Got the diagnosis yesterday. Macular hole. So, face down. This will be interesting (can't even bring myself to use more descriptive adjectives). I was always a side sleeper but due to rotator cuff issues I slowly adjusted to sleeping on my back which I 've been doing for about 7 years. I'm also one of those that loves a massage but when in the face down through the hole position, my nose stuffs up and I can't wait to turn over..I know...I have no choice if I want the healing process to be successful. Thank you for the original post, written in such a supportive and positive way. I want to hold hands with the "survivors".
gracenotes (author) from North Texas on May 08, 2012:
It's often difficult, for various reasons, to sleep face down. Your plan sounds about as good as I've heard to make this work. Sorry I can't offer any other solutions.
Mark H on May 07, 2012:
My bride will undergo her second vitrectomy in one year in 2 weeks. She is a beautiful rose but ,alas, she was a much smaller rose when we married 49 years ago, We rented the cusions and mirror,chair etc but my wife cannot sleep on her stomach because , ahem, it gets in the way. I was thinking of getting a large slab of foam rubber and cutting out part to fit her belley. ny advise on this?
gracenotes (author) from North Texas on May 01, 2012:
I hope your experience is OK. I had someone helping me, and they washed my hair while I bent my head down over the sink.
For bathing, I may have been able to take a shower. I don't remember. Seems the best way to keep your head down, anyway.
joystamp on April 30, 2012:
may 10th is my day -- petrified - renting equipment. ordering food deivery, can you shower - any more advice for me greatly appreciated - this has helped my mental state somewhat
prioritysam on April 25, 2012:
Good reading, I'm going in for my surgery tomorrow. thanks for all of the tips
gracenotes (author) from North Texas on January 12, 2012:
Pat, you are welcome. May your recovery experience be swift and not too boring.
Pat on January 12, 2012:
I also live in North Texas and had cataract surgery in September and October. I now have a macular pucker and I go back next week for a followup to see if it has improved. I suspect not. I was told by my surgeon that I will have to be face down for five days. I'm slowly getting used to the idea. Thank you for this wonderful information. It has been very helpful.
gracenotes (author) from North Texas on December 01, 2011:
Good luck with your surgery. I hope it goes well for you. It is a pleasure to see another comment on my hub.
Rosie on December 01, 2011:
Thank you for all your tips. I'm having the surgery in 5 days. I'm quite nervous and because of that my surgeon recommended general anaesthesia for which I am extremely grateful. I'm now trying to prepare my room and house. I've called to rent equipment which someone will come and install, and I've downloaded some very cool audiobook app and i might also learn to draw cartoons. I'm very lucky since I live with my family and have lots of younger sisters who will help me out and support me :) againg thanks for the tip I'll use them to prepare.
Justin on November 25, 2011:
Dear Heidi, I've prayed for your five-year-old child, for all those on this hub, for all those facing potential sight loss and for those that have vision loss. Peace and more prayers, Justin.
gracenotes (author) from North Texas on November 07, 2011:
Good luck with your surgery. Thanks for reading.
Gayle on November 07, 2011:
I am having surgery in 3 weeks, your info was great, never thought of the audio books or a portable DVD player....
gracenotes (author) from North Texas on November 05, 2011:
Heidi, thanks for coming by and leaving a comment. I hope it is not too difficult with the surgery for your 5-year-old.
Heidi on November 05, 2011:
My 5-year-old will be having this surgery next week. I'm grateful for the tips!
gracenotes (author) from North Texas on November 02, 2011:
Thank you so much for returning to this hub to tell about your surgery and recovery experience. My prayer worked? God is good, all the time!
I am glad that your surgery had a good outcome, and I hope there are no more problems.
Kate on November 02, 2011:
It is now 11 months since i had my vitrectomy,i had 10 days of face down but i could sleep on my side at night.
My vitrectomy was to repair a macular hole and i am glad to say was successful.
Last time i wrote here i was worried about the journey home from hospital as it was 4 hours on a ferry across the Irish sea,your prayer must have worked, the sea that day was as calm as a mill pond,and luckily i managed to book a cabin so i had some privacy while keeping my face down.
yaseen on October 31, 2011:
sir my face is very down also eyes i am not doing hand practice but my skin is to weak any medicine adivise me please i am from pakistan
gracenotes (author) from North Texas on October 29, 2011:
Starr, Well I agree that the positioning furniture is not too great. I didn't really use it except for watching DVD's and television.
As a pet owner, I sympathize with you about your dog. I hope you are getting over that event.
Star on October 28, 2011:
Good comments. I did not like the positioning furniture. I wrote a pamphlet on how to do this--because I got bad info, I sent my dog away so I would not look up--and he got killed. http://healthsasspresents.blogspot.com.
gracenotes (author) from North Texas on August 14, 2011:
Toniemail13, thanks for your comments. Let me emphasize that if you have macular pucker surgery, the odds of your having to do the face-down positioning are very slim. Mine was a special case, and thankfully, most of those surgeries are routine, with easy recovery.
It's a good thing that you're going to have a consult with a retinal specialist before doing cataract surgery. Your retinal specialist will determine how bad your macular pucker condition is, and whether or not surgery will help the condition. Sometimes it's better to have the cataract surgery first, then followed by the ERM peel. That's what I did. If you have the ERM peel before cataract surgery, your cataract is, in all probability, going to worsen anyway after the retinal surgery. In some cases, it may not matter much which surgery is done first.
If your macular pucker condition is not causing many problems, your surgeon may choose to leave them alone, and keep monitoring for any changes.
I hope this helps you.
toniemail13 on August 14, 2011:
I will be seeing an eye surgeon tomorrow for macular puckers in both eyes. These puckers were noticed by my cataract surgeon, who recommended I get a consult from the macular surgeon before cataract surgery.
Is macular pucker surgery usually done first?
Thank you for your insights.
gracenotes (author) from North Texas on March 12, 2011:
Crystolite, thank you for coming by.
Emma from Houston TX on March 12, 2011:
Nice info,thanks for sharing.
gracenotes (author) from North Texas on March 08, 2011:
Azure, thanks for your comments.
azure_sky from Somewhere on the Beach, if I am lucky :) on March 08, 2011:
Excellent and informative hub Grace!!! Thanks for putting this together!
gracenotes (author) from North Texas on March 07, 2011:
Betsy, I was not able to get back to see my retina specialist, so I'm still not sure why some surgeons would advocate patients sleeping on their side, instead of face-down. And I'm sorry I can't be more helpful about that issue. You'll have to ask your physician about that one. Physical therapy -- no. But it would be nice if one had a massage therapist to work out the tension in stiff neck and shoulder muscles.
betsy on March 07, 2011:
Is there positioning for sleeping on your side sAfely? Did your Dr. reccommen a physical therapist Is showering okay? ThaNk you for answering
gracenotes (author) from North Texas on March 07, 2011:
Betsy, I have walked around with my head lowered when I was recovering from surgery.
I can't answer about how much pain. It depends on the surgery and the kind of needles that your surgeon is using. I didn't have any pain with my vitrectomy, but that is because my surgeon used fine-gauge needles in the surgery. If your surgeon uses sutures, there could be some pain.
betsy on March 06, 2011:
what kind of pain is involved after surgery? Am fscing the surgery in a couple of weeks. Can you walk around waith your head down?
gracenotes (author) from North Texas on February 17, 2011:
Keitht, I'm glad you wrote the comment!
On my other hub, which is the last one linked on this article, I discussed the vitrectomy procedure. You can read it. You'll see from those comments that one fellow in Argentina who had a vitrectomy did not have to go face-down. Another person commented that they had to sleep on their side, which is easy.
I really had planned to ask my retinal specialist this question myself, and I will be seeing him probably on March 7, and if so, I will come back here and tell you what he said.
But to be honest, it would be best to ask your doctor or his physician assistant about this. It's really imperative that you are not left with doubts in your mind!
By the way, you asked the same question that I did about the air bubble. A retinal surgeon will refer to a "gas bubble" or an "air bubble," but they are the same thing. When I seemed confused about this, my surgeon looked at me and said, "Air IS a gas." It embarrassed me at the time, and I felt really stupid. Apparently some air bubbles are short-acting, and some are meant to be in the eye longer.
If you have to travel home by rail, believe me, you'll find a way to be face down if it's necessary. I recommend using one of those soft, horse-shoe shaped pillows.
Having said that, I really hope that you are spared having to assume the face-down position. Honestly!
Hope this helps.
Keitht on February 17, 2011:
Very useful inforn#mation. Many thanks.
I am booked for a vitrectomy in 2-3 weeks time but the consultant did not mention the face down recovery. Apparently I will have air injected into my eye rather than gas or saline. I wonder if that makes a significant difference? Apparently I can expect the air to be absorbed within a week. I will need to make a 50 mile rail journey after the op and wonder how that squares with keeping face down at what must be a critical time?
gracenotes (author) from North Texas on January 21, 2011:
I'm sorry to hear that. I hope you are seeking medical attention for the problem, and that you get some relief.
PARKAP on January 21, 2011:
hI i AM HAVING VERY DIZZY SPELLS AND HEADACHES AFTER LIFTING MY FACE AFTER FACE DOWN FOR 2 WEEKS
Will be grateful if anyone can suggest how to deal with this - direct to firstname.lastname@example.org
gracenotes (author) from North Texas on December 01, 2010:
As you know already, this isn't fun. I hope that your boyfriend has an easy time of it. Thanks for your comments. I consider it a great compliment that you took the time to add to my hub on face-down recovery after vitrectomy.
Megan on December 01, 2010:
Thanks for the tips! My boyfriend has had two vitrectomies, one of which included a face-down recovery. He's scheduled for another this Friday to repair a detached retina in his other eye, and we'll be sure to use your list to help him pass the time! Thanks again!
gracenotes (author) from North Texas on November 03, 2010:
I hope it goes well for you, and that the results of the repair surgery meet your expectations. I would not like having to cross the Irish sea on a ferry, but perhaps there is something the doctor can offer to make you more comfortable in case the seas get rough. I took a few moments just now to pray that everything will happen efficiently and that the journey won't have any rough spots. Thanks for your comments.
Kate on November 03, 2010:
I shall be having a vitrectomy to repair a macula hole in a few weeks time,what is worrying me is the journey home from hospital as i wont be able to fly it will be a 4 hour ferry crossing and the irish sea can be rough at this time of year.
gracenotes (author) from North Texas on October 30, 2010:
Thanks for the comment. It is very true.
s.m shahnawaz on October 29, 2010:
I passed 24 days in this position.you can do any thing if your vision at a risk.
gracenotes (author) from North Texas on August 23, 2010:
I am glad I had the surgery. I have noticed additional improvement in my vision, 3 months after surgery. The Lord be praised for that.
I don't know how I stayed face-down to sleep. The first night, I woke up many times, and had to shift positions slightly, but after that, I stayed in position and did not awaken much. I guess somehow the neural circuits were active and clicking because they knew what I needed to accomplish. Anyone who is having difficulty can take muscle relaxants and they'll be knocked out for 6 hours or so!
RTalloni on August 23, 2010:
I must say that your title certainly made me curious. Besides learning of something new, you made me thankful that I don't have such a problem. Three days is a long time for that position, but you made it and you have given those who have the same problem some good encouragement here. Good for you! May the Lord bless your continued recovery.
BTW, how on earth did you stay on your stomach when asleep? Tie yourself down?
gracenotes (author) from North Texas on August 18, 2010:
I am delighted to be able to help. Maybe you can come back here and let us know how you did! I wish you well.
vvzabalon on August 18, 2010:
Thank you very much for relating your experience. In a few
days I will be going through a similar procedure and will
have to face down for some time. This information will help
me to face this challenge with determination and not fear.
thank you again.
gracenotes (author) from North Texas on August 12, 2010:
Thanks Sandy. I should have taken a picture while I was in my "recovery" phase.
Thanks for stopping by.
Sandy Mertens from Wisconsin, USA on August 12, 2010:
Just reading this made me cringe. Interesting information on vitrectomy.
gracenotes (author) from North Texas on August 11, 2010:
Well, thank you. I just hope that you don't ever have to have surgery where this type of thing is required!
CMHypno from Other Side of the Sun on August 11, 2010:
You know, I had never heard of face down recovery before, so thanks for all the information and the tips, gracenotes