Post Operatative Instructions Example

**This is an example of the form your surgeon will fill out with instructions specific to your situation**

Patching of Operative Eye
__ 1st Night Post Surgery __ Day(s) Post Surgery __ Week(s) Post Surgery

Shielding of Operative Eye
__ 1st Night Post Surgery __ Night(s) Post Surgery __ Week(s) Post Surgery

Eye Drops
__ Tobradex 4 X Daily for __ Week(s)
__ Predforte 4 X Daily for __ Week(s)
__ Vigamox 4 X Daily for __ Week(s)

Pain Medication
Plain Tylenol / Tylenol #3 – max 2 pills every 4 hours

Positioning
__ Face Down
__ Right Side Down
__ Left Side Down
__ Head Elevated ____ Degrees
__ Sitting up
__ No Position Required

For __ Day(s) __ Week(s) **Showering- one day after surgery**

Follow up Appointments:
Day 1 Post Surgery: Date & Time: __________________________________
Royal Alex Hospital- Unit 22/Eye Clinic (#111) OR ARC- Suite 400, 10924-107 Ave

2 Weeks Post Surgery: Date & Time: ________________________________
Royal Alex Hospital- Unit 22/Eye Clinic (#111) OR ARC- Suite 400, 10924-107 Ave

Special Instructions:

  • Pain after vitrectomy should be mild and treatable with pain Tylenol
  • Pain after scleral buckle surgery is moderate and treatable with plain Tylenol or Tylenol #3.

**PLEASE CALL 780-448-1801 if you have increasingly severe eye pain or if you are nauseated and vomiting**