How should I position after surgery?
It is important to realize that the gas or oil bubble in your eye rises just like a bubble in a glass of champagne floats to the top. So how you position your eye and your head will determine where the bubble in your eye sits. Your retina is in the back of your eye. So depending on where the retinal defect is, you should position so the bubble most effectively covers the defect. Positioning is somewhat dependent on the size of the bubble in your eye. The larger the bubble, the less strict, in general, you need to be about your head position.
Assuming a very small bubble, if you have a macular hole, you should position after surgery looking straight toward the floor. This is best accomplished by sitting at a table and resting your forehead on your arm and looking toward the floor, or lying in bed with a flat pillow under your chest and a rolled towel under your forehead to leave a small breathing space for your mouth.
If you have a retinal detachment with a single break, you will need to position so that wherever that break is is at the highest point possible. So for example, if you have a retinal break at 12:00 O'clock, you should be sitting upright, looking straight ahead or slightly down. Usually the break is not directly at 12:00 O'clock, so you may have to tilt your head to one side or the other. Sometimes, a retinal detachment has many breaks in different places, or maybe there was a very large retinal defect, in that situation, your doctor my ask you to position from side to side.
Retinal detachments, for the first few days after surgery, sometimes require the patient to look toward the center of the earth for 15 minutes every hour or two so that while the retina is reattaching, the macula remains smooth. If you imagine the bubble on the retina something like an iron smoothing out a shirt, you can imagine how it is possible to get a retina fold as the retina is reattaching, much like it is possible to iron a fold into shirt. If a retina fold forms in the central vision, in the back of the eye, where the macula sits, the central vision can be permanently compromised. A little bit of face down positioning during the initial reattachment phase of the post-operative period can prevent the formation of a retinal fold.