Cataract surgery is a common and highly successful procedure that restores vision for millions of people annually. While the operation is quick and minimally invasive, following post-operative instructions is crucial for a smooth recovery and the best visual outcome. These instructions protect the eye during the initial healing period. A frequently asked question about post-operative care concerns blowing your nose.
Why Blowing Your Nose Creates Risk
Patients should avoid blowing their nose forcefully for at least the first week after surgery, or longer, based on their surgeon’s advice. This restriction relates to managing pressure within the head and eyes. Forceful nose blowing creates a rapid increase in pressure inside the nasal and sinus cavities.
This increased pressure, created by the forced exhalation against a closed airway, can transfer to the ocular cavity. The resulting spike in intraocular pressure (IOP) is temporary but could be significant enough to disturb the delicate surgical site. Modern cataract incisions are often small and self-sealing, meaning they rely on the eye’s natural pressure to keep them closed without sutures.
A sudden, forceful pressure change risks disturbing this fragile, healing wound. Potential complications, though rare, include the wound briefly reopening or causing a slight, temporary displacement of the newly implanted intraocular lens (IOL). Therefore, managing activities that increase internal pressure is a primary focus during the initial recovery phase.
Safe Ways to Manage Nasal Congestion
Since blowing is restricted, practical alternatives are necessary for managing congestion safely. Instead of forceful blowing, wipe the nose gently with a soft tissue to remove discharge. Avoid pressing hard on the nose or touching the area near the eyes.
Using a sterile saline nasal spray or rinse can help moisten the nasal passages and loosen mucus for easier, passive drainage. When using a saline rinse, it is important to avoid tilting the head too far forward or backward, which can create unnecessary strain. Patients should always consult their doctor before taking any over-the-counter decongestants or antihistamines, as some medications can have side effects.
If a sneeze is unavoidable, the most important action is to prevent the build-up of pressure. The patient should try to let the sneeze escape through an open mouth, which dissipates the force and prevents it from being channeled into the nasal cavity. Trying to hold a sneeze in is strongly discouraged because it significantly increases the internal pressure.
Other Activities That Increase Eye Pressure
Blowing the nose is one of several common activities that must be modified or avoided because they increase intraocular pressure. Heavy lifting, typically defined as anything over 5 to 10 pounds, is prohibited for several weeks. Strenuous activity or exercise should also be avoided until cleared by the surgeon.
Bending over at the waist, especially to pick up an object, should be avoided, as this movement causes the head to drop below the heart and increases eye pressure. Patients should instead practice squatting, keeping their head upright and level with their body, to retrieve items from the floor. Straining during a bowel movement also falls into the category of pressure-increasing activities.
To prevent straining, which can be a form of the Valsalva maneuver, doctors often recommend increasing fiber intake or using a stool softener following surgery. Patients must strictly avoid rubbing the operated eye, which can introduce bacteria and physically disrupt the healing incision. These precautions ensure the eye remains stable while the surgical site fully heals.