Enduring Face-Down Recovery after a Vitrectomy

You may be prepared for it. I hope so. 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 which 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 spending 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 just could not assume this position for long, 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?

A few hints

  • 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 DVD’s 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 for only three days, but yours may last for two weeks. Either way, you’ll have something to look forward to. When you go to the doctor and he gives you 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.

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Comments 57 comments

betty w 2 months ago

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

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gracenotes 8 months ago from North Texas Author

Angel and stepf,

I hope you are doing well after surgery and with your recovery!

angel 8 months ago

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 9 months ago

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.

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gracenotes 2 years ago from North Texas Author

Thank you Wvugirl! I hope the rest of that recovery goes well.

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wvugirl2007 2 years ago from Virginia

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.

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gracenotes 3 years ago from North Texas Author

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 3 years ago

thank you for all the information. My 11 years old son is having a surgery on December 19th. What other products can you recorded.

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gracenotes 4 years ago from North Texas Author

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 4 years ago

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".

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gracenotes 4 years ago from North Texas Author

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 4 years ago

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?

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gracenotes 4 years ago from North Texas Author


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 4 years ago

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 4 years ago

Good reading, I'm going in for my surgery tomorrow. thanks for all of the tips

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gracenotes 4 years ago from North Texas Author

Pat, you are welcome. May your recovery experience be swift and not too boring.

Pat 4 years ago

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.

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gracenotes 4 years ago from North Texas Author


Good luck with your surgery. I hope it goes well for you. It is a pleasure to see another comment on my hub.

Rosie 4 years ago

Hi everyone,

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 4 years ago

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.

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gracenotes 4 years ago from North Texas Author


Good luck with your surgery. Thanks for reading.

Gayle 4 years ago

I am having surgery in 3 weeks, your info was great, never thought of the audio books or a portable DVD player....

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gracenotes 4 years ago from North Texas Author

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 4 years ago

My 5-year-old will be having this surgery next week. I'm grateful for the tips!

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gracenotes 4 years ago from North Texas Author


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 4 years ago

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.

Many thanks.


yaseen 4 years ago

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

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gracenotes 4 years ago from North Texas Author

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 4 years ago

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.

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gracenotes 5 years ago from North Texas Author

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 5 years ago


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.


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gracenotes 5 years ago from North Texas Author

Crystolite, thank you for coming by.

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crystolite 5 years ago from Houston TX

Nice info,thanks for sharing.

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gracenotes 5 years ago from North Texas Author

Azure, thanks for your comments.

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azure_sky 5 years ago from Somewhere on the Beach, if I am lucky :)

Excellent and informative hub Grace!!! Thanks for putting this together!

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gracenotes 5 years ago from North Texas Author

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 5 years ago

Is there positioning for sleeping on your side sAfely? Did your Dr. reccommen a physical therapist Is showering okay? ThaNk you for answering

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gracenotes 5 years ago from North Texas Author

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 5 years ago

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?

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gracenotes 5 years ago from North Texas Author

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 5 years ago

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?

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gracenotes 5 years ago from North Texas Author


I'm sorry to hear that. I hope you are seeking medical attention for the problem, and that you get some relief.

PARKAP 5 years ago


Will be grateful if anyone can suggest how to deal with this - direct to

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gracenotes 5 years ago from North Texas Author


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 5 years ago

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!

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gracenotes 5 years ago from North Texas Author


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 5 years ago

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.

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gracenotes 5 years ago from North Texas Author

@s.m. shahnawaz,

Thanks for the comment. It is very true.

s.m shahnawaz 5 years ago

I passed 24 days in this can do any thing if your vision at a risk.

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gracenotes 6 years ago from North Texas Author


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 profile image

RTalloni 6 years ago from the short journey

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?

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gracenotes 6 years ago from North Texas Author


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 6 years ago

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.

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gracenotes 6 years ago from North Texas Author

Thanks Sandy. I should have taken a picture while I was in my "recovery" phase.

Thanks for stopping by.

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Sandyspider 6 years ago from Wisconsin, USA

Just reading this made me cringe. Interesting information on vitrectomy.

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gracenotes 6 years ago from North Texas Author

Well, thank you. I just hope that you don't ever have to have surgery where this type of thing is required!

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CMHypno 6 years ago from Other Side of the Sun

You know, I had never heard of face down recovery before, so thanks for all the information and the tips, gracenotes

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