Glaucoma surgery, such as a trabeculectomy or a tube shunt procedure, creates a new mechanism for fluid drainage to reduce intraocular pressure. Protecting the eye during the healing phase is essential for the procedure’s success and requires strict adherence to post-operative instructions, especially during sleep. Failing to protect the surgical site at night risks accidental injury or pressure on the globe, which can disrupt healing and potentially cause a damaging spike in eye pressure. Maintaining a safe sleep environment begins immediately after the procedure.
Essential Protective Positioning
The most important instruction for safe sleeping is to prevent direct pressure on the operated eye. You should sleep on your back, as this ensures the eye remains free from contact with the pillow or bedding. If sleeping on your back is difficult, you must only sleep on the side opposite the operated eye to maintain distance from the surgical site.
Avoid sleeping on your stomach or on the side where the surgery was performed. Direct contact can place pressure on the eye, compromising the integrity of the surgical wound or the newly created drainage pathway. For a period specified by your surgeon, you will need to wear a rigid protective eye shield at night.
This shield acts as a physical barrier, preventing accidental rubbing, bumping, or pressing on the eye while you are asleep. Secure the shield correctly with tape, ensuring the dome is over the eye and the edges rest only on the bony socket surrounding the eye. Elevating your head using a wedge pillow or two standard pillows also helps reduce intraocular pressure. Maintaining this slight head elevation, typically at a 30-degree angle, encourages proper fluid drainage and minimizes the overnight rise in eye pressure.
Managing Post-Operative Discomfort for Sleep
Managing the mild discomfort often felt after surgery is important for achieving restorative sleep. Your surgeon will prescribe or approve mild pain relievers, such as acetaminophen, which should be taken as directed before bedtime to maximize comfort. Avoid non-steroidal anti-inflammatory drugs like ibuprofen or aspirin for approximately five days post-surgery, unless instructed otherwise, as they can interfere with healing or increase the risk of bleeding.
Adhering to the schedule for prescribed antibiotic and steroid eye drops is an important part of the nightly routine. If drops are required shortly before sleep, administer them precisely as instructed. Wait a few minutes before lying down completely to allow the medication to absorb. Use supportive body pillows to prop your back or prevent you from unintentionally rolling onto the surgical side.
Creating an optimal sleep environment can help manage the stress of sleeping in an unfamiliar position. Ensure the bedroom is dark, quiet, and cool, which promotes the onset of sleep. Taking slow, deep breaths or engaging in a brief, calming activity before bed can help your body relax into the necessary position, supporting both recovery and sleep quality.
Timeline for Resuming Normal Sleep Habits
The period of strict adherence to protective sleep habits is temporary and depends on the healing speed of the eye. The requirement to sleep on your back or the non-operated side is typically most strict for the first one to two weeks following the procedure. During this initial time frame, the surgical wound is most vulnerable, and accidental pressure poses the greatest risk.
The nightly use of the protective eye shield is often required for a longer duration, commonly lasting between two to four weeks, but sometimes extending up to six weeks. The exact timeline is determined by your surgeon based on the type of glaucoma surgery performed and your individual healing progress, which they will assess during follow-up appointments. Full recovery, including the stabilization of eye pressure, often takes four to six weeks.
During this recovery window, you must also avoid strenuous activities, heavy lifting, or bending with your head below your heart just before bed. These actions can temporarily raise intraocular pressure and should be avoided until your surgeon gives clearance. Your doctor will provide the precise date when you can safely discontinue the shield and resume your preferred sleeping position.