Retinal Surgery Recovery: Face-Down Recovery After Retinal Surgery

 Retinal surgery recovery can feel straightforward until your surgeon says, “You’ll need to stay face down.” That instruction is common when a gas bubble is placed in the eye to gently press against a repaired area of the retina while it heals.

If you are wondering whether face-down positioning applies to you, here’s the simple answer: it is most often required after vitrectomy with a gas bubble for conditions like a macular hole or certain retinal detachment repairs, and it can sometimes be used for other procedures depending on where the bubble needs to apply pressure. Your exact timeline and positioning schedule should always be determined by your retinal surgeon. 

At Barnet Dulaney Perkins Eye Center, we help you understand what your retina needs now, what recovery typically looks like, and how to prepare for the days after surgery with a plan you can actually follow.

Why Face-Down Positioning is Prescribed

Think of the gas bubble like a temporary internal support. It floats, so gravity determines where it contacts the retina. When you keep your head in the right position, the bubble presses against the treated spot, helping the retina stay in place and reducing the risk that fluid slips back under the retina. 

That is why surgeons can be strict about positioning, especially early on. If the bubble shifts away from the treatment area, healing can be less predictable, and in some cases, it can increase the risk of complications or the need for additional treatment. 

What Types of Retinal Surgery Require Recovery Face-Down?

Face-down recovery is not required after every retina procedure. It is most commonly used when surgery includes placing a gas bubble, and the goal is to keep that bubble in contact with the exact area being repaired. 

Here are the situations most often associated with face-down positioning:

Vitrectomy with a gas bubble for macular hole repair

Macular hole surgery commonly involves vitrectomy and a gas bubble, and patients are often asked to remain face-down to help the hole close while the bubble is in place. 

Vitrectomy with a gas bubble for retinal detachment repair

For certain retinal detachments, surgeons use vitrectomy with air or gas to reattach the retina and support healing, then prescribe head positioning, face down or on a particular side, to keep the bubble where it is needed. 

Other vitrectomy-based repairs where bubble positioning matters

Some surgeons may recommend face-down positioning after procedures such as macular pucker surgery when a bubble or similar support is used to protect the repair. 

Procedures that Usually Do Not Require Face-Down Positioning

Many in-office retina treatments do not involve a gas bubble and typically do not require face-down recovery, for example, laser photocoagulation or cryotherapy for certain retinal tears. Your surgeon will tell you if positioning is needed in your situation. 

It is important to remember that some patients are instructed to use side-lying or upright positioning rather than full face-down, depending on the repair site. Follow the exact directions you are given, because “best position” is case-specific. 

How Long Will I Have to Stay Face Down?

There is no single universal schedule. Many patients are instructed to position for a set number of days, and some are asked to continue longer depending on healing and the type of bubble used. One common range discussed in patient guidance is 5 to 14 days, with some cases extending beyond that. 

Some clinics also provide very specific rules, for example, staying face down most of the time and only getting up for essentials, while emphasizing that the plan may be adjusted over time as the bubble dissolves and healing progresses. 

Retinal surgery recovery tip:

If you are unsure how strict your positioning needs to be, ask your surgeon one direct question: “How many hours per day, and what breaks are allowed?” Then follow that plan, not generic advice.

What the Gas Bubble Feels Like, and What You May See

A gas bubble affects vision while it is present, so blurry vision is common early on. As the bubble shrinks, many people notice a moving edge or line in their vision. 

How long the bubble lasts depends on the gas used. Patient education materials describe broad ranges, for example:

• Air bubbles may absorb in about 5 to 7 days
• SF6 gas may last about 10 days to a month
• C3F8 gas may last about 6 to 8 weeks

Your surgeon will tell you what type of bubble was used and what to expect based on your case.

Safety rules during retinal surgery recovery with a gas bubble

If you have a gas bubble, travel and anesthesia details matter.

Do not fly or go to high altitude while the bubble is present

Gas can expand as altitude changes, which can dangerously raise eye pressure. Multiple patient resources warn against flying and high-altitude travel until your surgeon confirms the bubble is gone. 

Tell every clinician you have a gas bubble before any anesthesia

If you need emergency care or another procedure, tell the care team you recently had retina surgery and whether a gas bubble was used. Some postoperative instructions specifically advise coordination with anesthesia teams before other surgeries. 

Driving is usually limited at first

Driving may be restricted while vision is blurry, depth perception is affected, or you still have a bubble. Get your surgeon’s clearance before returning to driving. 

How to prepare your home before surgery

A smoother recovery starts with setup. You want fewer surprises once you are home.

Plan help for essentials

Many patients need assistance with meals, errands, childcare, and driving for at least a few days. Face-down positioning makes simple tasks harder, so build your support plan before surgery. 

Consider renting positioning equipment

Specialty face-down chairs, cushions, and mirrors can make positioning more tolerable. Some practices recommend renting a face-down system, such as a chair or massage-table style setup, and having it ready before surgery. 

Stock your “no-strain” entertainment

Audiobooks, podcasts, playlists, and voice-to-text can help you stay connected without needing to look up at screens. 

Set up a recovery station

Pick one main area with: water, snacks, prescribed drops, tissues, chargers, and a way to communicate hands-free. Small convenience wins add up during retinal surgery recovery.

How to make face-down positioning more comfortable

Face-down recovery can strain the neck, back, and shoulders. Comfort matters because comfort improves compliance.

Use support, not willpower

Positioning is hard to “muscle through” without support. Cushions, cradles, and properly fitted equipment reduce pressure points and help you maintain the correct angle longer. 

Move smart, not fast

You can usually get up to use the restroom and handle essentials, and many instructions emphasize looking downward when you move so you maintain the correct head angle. Follow your surgeon’s specific rules on breaks. 

Protect your skin and breathing

Long periods on pillows can irritate the skin. Breathable fabrics and small adjustments can help. If you feel short of breath, develop severe pain, or cannot tolerate the position, call your surgeon’s office for guidance. 

What else is Normal After Retinal Surgery?

Recovery varies, but general postsurgical guidance often includes:

• Blurry vision early on
• Temporary increase in flashes or floaters in some cases
• Prescription drops, often including antibiotic and steroid drops, based on your surgeon’s plan
• Activity restrictions, such as avoiding strenuous activity for a period of time 

If you experience sudden worsening of vision, severe pain, or a curtain-like shadow, treat it as an emergency and contact your eye care team right away.

FAQ: Face-Down Recovery After Retinal Surgery

Does every retinal surgery require the patient to be positioned face down?

No. Face-down positioning is most commonly used when a gas bubble is placed in the eye, especially for macular hole repair and some retinal detachment repairs. 

What if my surgeon says side-lying instead of face down?

That can be appropriate depending on where the bubble needs to apply pressure. Follow your specific instructions because positioning is tailored to the repair. 

How many days will it take me to do this?

Many patients are instructed to position for several days, and some for longer. Patient guidance often mentions a range of 5 to 14 days, with the timeline adjusted based on healing and the surgeon’s preference. 

How long does the gas bubble last?

It depends on the gas used. Air may absorb in about 5 to 7 days, SF6 may last about 10 days to a month, and C3F8 may last about 6 to 8 weeks, although individual timelines vary. 

Can I fly if I feel fine?

Not if you still have a gas bubble. Air travel and high altitude can cause the bubble to expand, raising eye pressure to dangerous levels. Wait until your surgeon confirms the bubble is gone. 

Will my vision be blurry the whole time?

Blurry vision is common early, especially with a bubble. Vision often improves gradually as the bubble shrinks and the retina heals, and some people notice the bubble edge as a moving line. 

What if I cannot tolerate face-down positioning?

Call your surgeon’s office. They can suggest equipment options, comfort strategies, or alternative positioning if medically appropriate.

How do I know my recovery is on track?

Your follow-up visits and imaging help confirm healing. If you notice sudden worsening vision, severe pain, or a curtain-like shadow, contact your eye care team urgently.

Ready to plan your retinal surgery recovery?

If you have a macular hole, retinal detachment, or another retinal condition that may require surgery, schedule an evaluation with Barnet Dulaney Perkins Eye Center so we can review your diagnosis, explain whether face-down positioning applies to your procedure, and help you prepare for a safer, more confident recovery.