If you’ve been diagnosed with a retinal detachment and are waiting for surgery, your main job is to keep still, protect the affected eye, and avoid anything that could make the detachment worse. The hours or days before your procedure matter. How you position your body, what you eat, and how much you move can all influence your surgical outcome.
Why Timing Matters
Retinal detachment surgery is scheduled based on whether the center of your vision (the macula) is still attached. If it is, surgeons typically aim to operate within 24 hours to preserve the best possible vision. About 80% of these cases don’t progress further within 48 hours, so a slight delay doesn’t always cause harm, but sooner is better.
If the macula has already detached, the goal is surgery within two to three days of symptom onset. Waiting longer than three days is associated with worse visual outcomes, and delays beyond a week show a more significant drop in final vision. Either way, the waiting period isn’t passive. What you do during it directly affects how your retina behaves before the surgeon can repair it.
Head and Body Positioning
Your surgeon may give you specific positioning instructions based on where your retinal tear is located. The goal is to use gravity to keep the detached retina as close to the back wall of the eye as possible, slowing progression. If you haven’t received instructions, ask.
General positioning guidance follows this logic: if the tear is in the upper part of your retina, you’ll likely be asked to sit upright or sleep propped at a 45-degree angle. If the tear is on the left or right side, you’ll be positioned on the opposite cheek, so the detachment settles back toward the wall of the eye rather than peeling further away. For tears along the bottom of the retina, lying on either side is typically recommended.
These positions may feel uncomfortable, especially for sleeping. Use pillows to support yourself, and try to maintain the position as consistently as you can, both day and night.
Movements to Avoid
The vitreous gel inside your eye tugs on the retina every time your head moves sharply. Rapid head turns, jerking motions, and jarring activities can worsen a detachment. During the waiting period, keep your movements slow and deliberate.
Avoid bending at the waist. If you need to pick something up, squat at the knees instead. Don’t lift anything heavy. Straining of any kind, including during bowel movements, increases pressure inside the eye. If constipation is an issue, a gentle over-the-counter stool softener can help. Skip exercise entirely, even walking briskly. The general principle is: if it raises your heart rate or makes you hold your breath, don’t do it.
Protecting Your Eye
Your surgeon may provide a rigid eye shield or ask you to wear one. A shield prevents accidental pressure on the eye while you sleep or move around. If you’ve been given one, tape it in place over the eye rather than pressing it against your face. Try not to rub or touch the affected eye, and keep both eyes relatively still. Because your eyes move together, even reading or scrolling on a screen causes the affected eye to track along. Minimizing rapid eye movements is a reasonable precaution. Listening to audiobooks or podcasts is a good alternative to reading or watching video.
Eating and Fasting Before Surgery
Retinal detachment repair often requires general anesthesia or sedation, which means fasting rules apply. The standard guidelines are straightforward: stop eating solid food at least 6 hours before your scheduled surgery time. Clear liquids like water, black coffee, or apple juice are fine up to 2 hours before. Fatty or fried foods take longer to digest, so if surgery could happen within 8 hours, skip them entirely.
If your surgery is being treated as an emergency and the timing is uncertain, your safest approach is to stop eating as soon as you’re told surgery is likely. Ask your surgical team for specific instructions, as fasting rules can vary slightly by hospital.
Medications and Blood Thinners
If you take blood thinners or antiplatelet medications like aspirin, you may wonder whether to stop them. The current trend in vitreoretinal surgery is increasingly toward continuing these medications rather than stopping them. Stopping blood thinners carries its own serious risks, including stroke and heart attack, and the evidence suggests that continuing them doesn’t meaningfully increase bleeding complications during retinal surgery.
That said, there’s no universal protocol. Some surgeons still prefer to pause certain blood thinners, particularly warfarin, if your risk of blood clots is low. Do not stop or change any medication on your own. Tell your surgical team exactly what you take, including over-the-counter supplements like fish oil or vitamin E, and let them make the call.
Continue using any prescribed eye drops, such as glaucoma medications, unless told otherwise.
Signs the Detachment Is Getting Worse
While waiting, monitor your vision in the affected eye. Some symptoms suggest the detachment is progressing and may require you to contact your surgeon or go to the emergency room sooner than planned:
- A growing shadow or curtain spreading across your field of vision, especially if it moves toward the center
- A sudden increase in floaters, the small dark specks or squiggly lines drifting across your vision
- New or more frequent flashes of light
- Worsening blurriness or a noticeable drop in your central vision
Any of these changes, particularly a curtain-like shadow expanding toward your central vision, suggests the detachment is advancing and the surgical timeline may need to move up.
Driving and Getting to Surgery
Do not drive yourself to the hospital. Retinal detachment reduces your peripheral vision and can cause blurriness or blind spots that make driving unsafe. After surgery, you’ll be temporarily unable to drive as well, sometimes for weeks or months depending on your recovery. Arrange for someone to both bring you to the hospital and take you home.
What to Expect From Surgery
Knowing what’s ahead can make the waiting period less stressful. Retinal reattachment procedures have high success rates, with the retina successfully repaired in about 80% to 90% of uncomplicated cases after a single surgery. About 14% of patients experience a re-detachment over the following years, which can be repaired with a second procedure.
After surgery, you’ll likely be given positioning instructions again, potentially including face-down positioning for days or even weeks. Recovery takes time. In one study, activities like driving, gardening, and returning to work were restricted for six weeks after surgery. Your surgeon will give you a specific timeline, but planning for several weeks of limited activity is realistic.
Pack a bag for the hospital that includes comfortable clothing, your medications list, your insurance information, and anything you need for an overnight stay. Wear a button-up shirt so you don’t have to pull clothing over your head afterward. If you use a CPAP machine or have other medical equipment, bring it along.