A gas bubble is injected into the eye after retinal surgery (like vitrectomy) to act as a temporary internal scaffold, or tamponade, holding the retina in place and pressing it against the back of the eye so it can heal properly from tears or holes, preventing it from detaching again while the eye's natural fluid replaces the gas over weeks.
Inside your eye, the gas bubble maintains a constant internal pressure—so the differential can cause the bubble to expand, dangerously increasing intraocular pressure and risking pain or damage to the optic nerve.
The duration of the bubble also depends on the type of gas the doctor used during surgery. The most used gases are the SF6, sulfur hexafluoride and the C3F8, perfluoropropane, the latter is used for more complex retinal surgeries. The SF6 usually lasts from 10 days to 1 month while the C3F8 lasts 6 to 8 weeks.
After some types of retinal surgery, you will need to keep your head in a face-down or sideways position. This is because a gas bubble has been put in your eye. Recovering with your head down allows the bubble to float into the correct position. The bubble holds the retina in place to heal correctly.
I see a black spot after my eye injection. Is that a problem? No, the black spot is an air bubble and will resolve within 24 hours. The air is often trapped in the needle and is injected with the medication.
You're advised not to drive after your operation while the gas bubble is still present in your eye. You'll notice the bubble shrinking and will be aware when it has completely gone. This can take several weeks, so ask your specialist if you're unsure when you can start driving again.
You should not rub your injected eye. You should not wash your face and hair or shower for 48 hours. You should not swim for a week after the injection. You may be given a follow-up appointment after the injection or course of injections, or a 'vision and scan' will be performed on the day and reviewed virtually.
You will become aware of a line in your vision resembling a spirit level, and it may feel as though you are seeing “underwater”. The gas will progressively absorb until just a small bubble is noticeable in the bottom of your vision before it also completely disappears.
Complications or risks of a vitrectomy include infection, bleeding, a retinal tear and low or high eye pressure.
If you have a gas bubble in your eye you should not fly in an airplane until advised it is safe to do so by the doctor as the pressure difference affects the bubble size and can cause severe pain.
Precautions With an Intraocular Gas Bubble
I recommend against air or high-altitude travel for any patient with an intraocular gas bubble. Diving, particularly scuba diving, could also result in contraction and expansion of the intraocular gas bubble and is not recommended.
For the first 48 hours after the surgery, it is important to rest as much as possible. The best thing to do is to simply relax in bed or in a chair with both eyes closed.
Advise all health care providers that you have a gas bubble in your eye before undergoing any surgical or dental procedure or hyperbaric oxygen therapy and have them contact your Ophthalmologist.
Eye irritation from gasoline vapors begins at about 200 ppm. Inflammation is generally slight. When splashed in the eye, gasoline may cause burning pain and transient corneal injury. Chronic exposure to gasoline may cause damage to the cornea, retina, and ciliary body.
Gas is commonly used in 'vitrectomy' eye operations to keep the retina in place whilst it is healing. A vitrectomy is a surgical procedure that removes the clear, jelly-like fluid in the central cavity of the eye so that the retina can be operated on.
Avoid reading or computer work. This also includes use of mobile devices such as iPhones, smart phones, and tablets. You may watch television as this involves less eye movement and strain but remain at a distance of at least 6 feet or more.
After vitrectomy surgery, the retina heals over weeks or months, and vision tends to improve as the retina swelling from the membrane subsides.
In Australia, Medicare covers vitrectomy, but only at hospitals and clinics with the specialised equipment needed for the procedure. For insured private patients, out-of-pocket costs usually fall between $500 and $2,000, depending on how complex the surgery is and if other procedures are done at the same time.
Other Activities: You may resume most of your activities around the house including most routine chores. However, do not bend below your waist, move suddenly, straining or lifting more than 20 pounds for the first 2 weeks after surgery. Bending should be from the knees, to keep your head above your heart.
Air travel or any significant pressure changes (like scuba diving) can cause this gas bubble to expand, leading to severe damage or even blindness. Stay at your surgery's altitude until your doctor confirms the gas bubble is gone.
Early signs of an eye stroke (retinal artery occlusion or ischemic optic neuropathy) typically involve sudden, painless vision loss or changes, most often in only one eye, including blurred vision, blind spots, floaters, or a dark shadow covering part of your sight. It often happens upon waking and is a medical emergency requiring immediate attention to potentially save sight and identify a risk for a full stroke.
You need to maintain a specific head position for at least three days after surgery. You will need to sleep with head tilted to the side opposite to where the retina break is found at the time of surgery to allow the gas bubble to keep the retina in place around the break area until the retina seals in that area.
“High eye pressure can interfere with the incision before it fully heals,” says Eghrari. “Positions that put your head below your waist, such as bending over, can also increase eye pressure and should be avoided initially after surgery.”
However, it's very important that you take it easy and rest for the first two or three days following the operation. During this time, avoid doing strenuous activities, such as housework or exercise after cataract surgery. This will give your eyes the time they need to heal.
You should avoid getting water in the eye, swimming or using eye make up for the one week after the injection. Avoid rubbing the eye There are no restrictions on watching TV, working on the computer or travelling after the injection.