Cataract and retinal surgery: eye drops, the shield, positioning and warning signs
- Safe practice
After eye surgery the nurse protects the eye, teaches clean eye-drop technique, helps keep the ordered head position and teaches the warning signs.
What it is
Cataract surgery removes the clouded lens and usually puts in an artificial lens; it is a short outpatient operation, normally under local anaesthesia, with a follow-up visit the next day and about two weeks of recovery. Retinal detachment is urgent: new flashes, floaters or a curtain over the vision need care within 24 hours. It is repaired with laser, a gas bubble (pneumatic retinopexy), a scleral buckle or vitrectomy. Nursing care after both operations is protection of the eye, clean eye-drop technique, the activity limits the surgeon sets and, after a gas bubble, the head position and the ban on flying. The patient also learns the signs that need a call to the surgeon.
What it requires
- The eye to be operated on is confirmed and marked as the surgical safety protocol states.
- Eye drops are given as ordered, to prevent infection, reduce inflammation and aid healing.
- Light activities only; the surgeon decides when strenuous activity, sex and driving can resume.
- Soap and water are kept out of the eye for the first few days.
- Dark sunglasses are worn outdoors after the patch comes off.
Components
- Before surgery: identification of the eye and a driver for the way home.
- Protection of the eye: patch or shield, no soap or water in the eye.
- Eye-drop technique and timing.
- Head position and travel limits after a gas bubble.
- Warning signs and follow-up.
How it is applied (and why)
- Confirm the eye to be operated on with the patient and the record, as the surgical safety checklist requires.
- Check that someone will drive the patient home: the patient cannot drive after the operation.
- Keep the patch or shield on as ordered until the follow-up visit: it protects the healing eye.
- Teach hand washing before and after drops and not to touch the dropper tip to the eye or lashes: it prevents infection.
- Teach one drop into the lower-lid pocket, eyes closed for 2–3 minutes, and at least five minutes between different drops.
- Remind the patient to keep soap and water out of the eye and to follow the surgeon's limits on activity.
- After a gas-bubble repair, help the patient keep the ordered head position for the whole time: the bubble must press on the retina.
- Teach no flying or high-altitude travel until the surgeon confirms that the bubble has dissolved.
- Teach the warning signs and how to contact the surgeon: early care protects vision.
In nursing practice
- Rare complications of cataract surgery are infection and bleeding, which can cause lasting vision problems.
- Risks of retinal repair include bleeding, raised eye pressure, infection and incomplete repair needing more surgery.
- Vision after cataract surgery may not be perfect when other eye disease, such as macular degeneration, is present.
- For daily care of a person with low vision, see sensory alterations; for drop technique, see the other routes of administration.
Common mistakes
- Touching the dropper tip to the eye, the lashes or another surface.
- Giving two different drops one after the other without waiting.
- Letting the patient lie on the back when a face-down position was ordered.
- Discharging a patient with a gas bubble without teaching the ban on flying.
Test yourself
Think of the answer, then tap the question to see it.
Why must a patient with a gas bubble after retinal repair keep a set head position?
The bubble has to press the retina back into place; the head stays face down or turned to one side for days or weeks, as ordered.
Why may a patient with a gas bubble in the eye not fly?
Flying or travel to high altitude is avoided until the bubble dissolves, as the surgeon confirms.
Which symptoms suggest retinal detachment, and how fast is care needed?
New flashes of light, new floaters or a curtain or shadow over part of the vision; care is needed within 24 hours.
How long should a patient wait between two different eye drops in the same eye?
At least five minutes, unless the instructions for a specific drop say otherwise.
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Cataract removal (MedlinePlus, U.S. National Library of Medicine, 2025); Retinal detachment (MedlinePlus, U.S. National Library of Medicine, 2025); Retinal detachment repair (MedlinePlus, U.S. National Library of Medicine, 2025); How to use eyedrops (MedlinePlus, U.S. National Library of Medicine, 2025).
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Representative model, for educational purposes only.