Eyelid Surgery (Local Anaesthetic)
Having an eyelid operation under local anaesthetic
How should I prepare for the operation?
1) Can I eat and drink as normal?
2) Should I take my blood thinning medication: aspirin, warfarin, or clopidogrel?
Blood thinning medications can prolong your operation. For certain operations they need to be stopped beforehand. The surgeon will decide this when they arrange the operation and give you instructions on when to stop these medications.
Patients who take both Aspirin and Clopidogrel must inform the surgeon beforehand, as one of these medications usually must be stopped beforehand.
3) Should I take my other normal medication?
Yes - this is very important.
4) What should I wear?
Comfy cotton clothes without a high collar are best.
- Try to avoid nylon clothes or underwear.
- Avoid very smart clothes as occasionally they come into contact with spots of either antiseptic or blood. Bring a change of top with you if you wish.
5) Do I need to bring anything else with me?
Bring all medication you need during the daytime in case you are delayed getting home.
- Ideally bring a relative or friend to accompany you home, but suggest that they bring a book.
6) Will I be able to drive home?
No, you should not drive. Please arrange for someone to take you home. Public transport is normally unsuitable. If you need transport providing, please contact your GP.
7) What about make-up?
Avoid using facial make-up including mascara and eyeliner on the day of surgery.
8) What about showering and hair washing before the operation?
In the interests of your optimal care, you should arrive for surgery as clean as possible with your hair washed as recently as is practicable.
9) What will happen when I attend for the operation?
- The day case nurse will check you in and answer any queries you may have.
- You will be taken to the operating suite 15-20 minutes before the operation.
- You will be taken to the anaesthetic room and the details of the operation will be checked.
- Numbing the eyelid (local anaesthetic) involves eyedrops followed by a fine needle. We take steps to make this part as comfortable as possible but transient discomfort is common. This usually wears off within seconds.
10) How long will the whole procedure take?
Eyelid operations are extremely variable and can take anything from 5 minutes to 2 hours or more. The doctor will usually have given you an estimate of how long your particular operation will take. Although we try to be accurate, the surgery can sometimes take longer and you should be prepared for this.
11) Will it be painful?
- After the anaesthetic has numbed the eyelid the procedure should be entirely comfortable. If you do experience any discomfort or pain it is important to tell the doctor immediately and they can top up the anaesthetic. This is occasionally required.
- Some patients find it uncomfortable to lie still during the operation, perhaps due to neck or back problems. If this happens tell the doctor immediately and they will stop to allow you to change position.
12) What happens after the operation?
- At the end of the operation, the doctor will give you any verbal instructions required.
- You will be taken to the recovery suite and then back to the day-case unit, where you will be offered a hot drink.
- You will receive further instructions for your post-operative care and any queries will be answered.
- Any postoperative medication will be given to you.
13) What about painkillers?
If you require any painkillers immediately after the operation these will be given to you. Most eyelid operations are not very painful afterwards, and paracetamol is usually sufficient for the few days after the operation. If you are unsure about what to take please discuss this with the nurse after the operation.
14) Will I have a dressing on the eye after surgery?
- Sometimes a dressing is needed to protect the wound. This may be left for a few hours, overnight, or for up to a week. The doctor and nurse will give you instructions about this before you leave. While the dressing is in place, you must keep it dry.
Please note that you are not allowed to drive if the dressing covers your eye.
- Patients having surgery on both sides are never discharged with dressings on both eyes. Similarly, if you are having an operation near to your only good seeing eye, then no dressing will be used.
15) Will I have a check up after the operation?
If you need a check up after the operation, then the appointment will be made before you go home. Commonly any check-up will be 1-6 weeks after surgery.
16) What about the stitches?
- Many eyelid operations only require dissolving stitches, however these stitches can last for many weeks before they finally disappear. They can be removed at the check–up visit, however it is rarely essential.
- For operations where permanent stitches are used, the check-up visit is timed for when the stitches need removal. This is usually 5-10 days after surgery.
- After certain eyelid operations, cotton or plastic bolsters are left attached to the skin. These are also removed at the check-up visit.
17) What do I do about washing after the operation?
- Any dressing must be kept dry, so do not wash this area until the dressing is removed.
- Otherwise you can shower or wash your hair, as normal. However you should be very gentle in handling the wound for the first 2 weeks.
Never use a towel or face cloth near the wound for the first 2 weeks: this would risk infection.
- If the wound looks fine then do not touch it at all.
- If it appears to need cleaning (for example to remove dried blood or sticky secretions),then dab it very gently with clean cotton wool / eye pads wetted with cooled, boiled water.
- It is particularly important that you do not wipe or drag the lower eyelid after an operation as this will stretch it and may damage the success of the operation. Therefore only dab this area to clean it.
18) What do I do if I need to put in drops after an operation on my lower eyelid?
You must always avoid stretching the bottom eyelid or you risk undoing an operations success. Therefore if drops are needed, instill them tilting your head back and lifting the top eyelid instead.
19) What should the eyelid look like shortly after the operation?
Bruising is normal and this can spread to both eyelids and to the lower cheek before it subsides. Bruising normally settles in 2 weeks, but severe bruising can last longer.
- The area of the operation is always swollen after an operation and this can be worse the following morning. Sleeping almost upright for the first 2 nights can help to reduce this.
Over the first few days the eyelid may become more red and it may also become itchy. This will often last for days or even weeks. This phase is normal, provided that any discomfort is gradually settling. However, if the eyelid starts to become more red and more painful, then please see your doctor or come to the eye casualty.