How Much Pain Is Normal After Retina Surgery?
Start Here: The Pain That Means Call Today
Most sore eyes after retina surgery are just healing. A few are not. Call your surgeon the same day if you notice any of these. At night, use the on-call number.
- Severe eye pain
- Pain that grows worse each hour
- Pain your painkiller no longer touches
- New loss of vision
- A new curtain or shadow across your sight
- A very red eye with thick discharge
- Pain with headache and feeling sick
The American Academy of Ophthalmology says to call right away if eye pain keeps getting worse after surgery, an eye injection or an eye injury1. It also says an infection inside the eye can cost sight if it is not treated in time1. That infection is rare, and treatable when caught early. That is why this list leads.
The rest of this page is about ordinary healing pain, which is what nearly everyone gets. It is dull, scratchy and boring, and fades week by week.
The list above is different. It covers the few situations where waiting a day changes what your surgeon can do.
Healing pain has a shape. It is loudest in the first day or two, then steps down. A long journey or a heavy day of posturing can set it back.
The pattern to act on is different: pain climbing steadily over 24 to 48 hours, pain that starts waking you again, or pain arriving with new blurring or redness. That is a trend, not a bad afternoon, and a trend earns a phone call.
Pain After Retina Surgery at a Glance
Some soreness is expected, and it should be easing rather than building. Most people describe an ache, a gritty feeling, or something stuck under the lid, not the sharp pain they braced for.
The American Academy of Ophthalmology says pain is very rare after vitrectomy, but that a scratchy, sandy or gritty feeling, as if something is inside the eye, is common and settles with the medicines and with time2. If that is your week, you are in the ordinary lane.
Days, not months, for most of it. In a study that followed 87 people after 20-gauge vitrectomy, 43 of the 87 reported eye pain on the first day. By two months that had fallen to 11 of the 87. Most rated it mild or moderate, at 1 to 5 on a 10-point scale, and only four people were given painkillers for eye pain3.
Two cautions. This was one study at one centre, using the older, larger 20-gauge instruments. Most retina surgery today uses smaller ones that often need no stitches, so your own week may be gentler.
The common report is a bruised, heavy ache around and behind the eye for the first few days, worse when you look far to one side. On top sits grittiness, watering, a swollen lid.
Both usually ease steadily. In the same study, about a quarter still noticed grittiness and dryness two months on, so a scratchy eye at that stage is not a sign that something has gone wrong3.
What Your Pain Probably Means
Retina surgery is done through the white of the eye, and the tissue over it is thin and full of nerves. Handling that surface, plus the numbing injection and the lid holder, leaves the front of your eye irritated even though the work happened at the back. That is why it feels like a speck of grit, not a wound.
A steady, dull ache that answers to your pain relief, and is better each day, is the ordinary picture. It does not mean the repair is failing. What deserves attention is a change in direction. Pain worse today than yesterday, and worse again tomorrow, is what your team wants to hear about.
Why Your Eye Hurts After Retina Surgery
The most common source of discomfort is the surface of the eye, not the retina. Stitches, where used, sit under the upper lid and rub with every blink until they dissolve or are removed. Eyes are also drier after surgery, and drops given several times a day can sting briefly. Both are irritating rather than dangerous, and both improve as the surface heals.
A rise in pressure inside the eye is a real cause of early pain, and one reason you are seen again so soon. In a review of 294 eyes that had vitrectomy for a detached retina, 98 eyes had a pressure above 20 mmHg within the first month, and about half of those readings turned up at the one-week check4.
That is roughly 33 of every 100 eyes in one hospital's records. Pressure pain often comes as a heavy brow ache, sometimes with feeling sick, and is worth reporting.
A buckle is a silicone band placed around the outside of the eye, so the surgeon works between the muscles that move it. Aching when you look sideways, and a bruised socket, are usual.
In a randomized trial of 45 people having scleral buckle surgery, the standard-care group rated pain on the day of surgery at an average of 5.64 out of 10. By the first and seventh days there was no meaningful difference between them and the group given an extra anti-inflammatory dose5. Buckle day is often genuinely uncomfortable, and is usually the worst one.
MedlinePlus says that after a gas bubble repair the head is kept face down or turned to one side for several days or weeks, and that people with a gas bubble may not fly or go to high altitudes until it dissolves, which most often happens within a few weeks6. The Academy gives the same travel rule and adds scuba diving, because a rapid change in altitude changes the size of the bubble2.
The bubble itself does not usually hurt. The posture does. Neck, shoulder and lower back pain most often ruin the first week, and say nothing about your eye.
Infection inside the eye is why severe pain is taken seriously. It is uncommon. In a hospital series of 111,876 vitrectomies, clearly evident infection inside the eye occurred at a rate of 4.0 per 10,000 operations. That was 5.7 per 10,000 after older 20-gauge surgery and 1.2 per 10,000 after small-gauge surgery, and 73.4 of every 100 affected patients came in within the first week7.
That is around 4 in every 10,000 people, fewer with modern instruments. The odds sit firmly on your side, which is exactly why an early call matters when something changes.
What Normal and Not-Normal Feel Like
Grittiness, watering, a heavy lid, mild aching that answers to pain relief, fading redness, and blurry vision that wobbles day to day are ordinary. A gas bubble often looks like a dark line that drops lower as it shrinks, and that is expected. One thing is different. A new shower of floaters, or a new shadow or curtain across your sight, should be reported the same day, because the retina may need looking at again.
Severe pain, escalating pain, pain plus a drop in vision, pain plus thick discharge, and pain plus nausea with a heavy brow all earn a same-day call. So does a new shadow or curtain, and pain that starts fresh after a good week. You are not expected to work out the cause. That is what the examination is for, and the clinic would far rather check a comfortable eye than miss an uncomfortable one.
This table is a rough sorting guide, not a replacement for your surgeon's advice.
| What you notice | Usually ordinary | Worth a same-day call |
|---|---|---|
| Aching | Dull, easing day by day | Severe, or climbing over 24 to 48 hours |
| Vision | Blurry, steady or improving | Clearly dropping again |
| Redness | Fading, no discharge | Deep red with thick discharge |
| Other signs | Tired eye, watering | Nausea with a heavy brow ache |
Not every pain after retina surgery is eye pain. Neck and shoulder pain from posturing, sinus pressure, tension headache from squinting, and jaw ache from clenching overnight all get blamed on the eye. A useful test is whether the pain changes when you move your eye or shift posture.
How Your Team Works Out What Is Causing the Pain
Expect the equipment you have already met. Your vision is measured, the pressure checked, and the eye examined with a bright light and a lens, usually after drops that widen the pupil. Bring your drop bottles, or a photograph of them, and be ready to say when the pain started and what makes it worse. That history often points to the answer.
Pressure is quick to measure and explains much early pain, so it is checked first. A raised reading is often handled with drops or tablets, and the ache settles as the number comes down. A low reading matters too, since it can follow a leak at a surgical port. Either way, the number is information, not a verdict.
If the examination raises a real concern about infection, your team may take a sample of fluid from inside the eye and give antibiotic treatment directly into it. This is done urgently, not at the next routine slot. Being told it is being considered is unsettling, and it is worth knowing that most people sent in for a same-day check are examined, reassured, and sent home with a change to their drops.
Easing Ordinary Discomfort While You Heal
Your surgeon's instructions outrank anything on this page, because the right painkiller depends on your other medicines and conditions. Many teams suggest a simple over-the-counter painkiller for the first days, and some prescribe something stronger for the first night after a buckle. Ask before adding anything of your own, and say if it is not holding.
Posturing pain is real, and one of the few parts of recovery you can actively improve. In a randomized trial of 61 people posturing face down after retinal surgery, those given a structured stretching program reported lower median pain on day three than the control group: 2 compared with 5 at the back of the neck, 1 compared with 3 at the shoulder, and 1 compared with 4 in the lower back. In that group, 26 of 30 people said they were satisfied with it8.
That was one small trial, with stretches taught by a professional. Still, it is worth raising with your team, along with face-down cushions and a rented support chair.
Risks, Complications and the Realistic Outlook
Most pain after surgery is surface irritation or pressure, and both are treatable in clinic. The serious cause, infection inside the eye, sat at roughly 4 in every 10,000 vitrectomies in one large hospital series, lowest with modern small-gauge surgery7. That number is comforting, and it does not make the same-day rule optional. Rare things still happen to somebody, and delay costs the benefit of early treatment.
The Academy lists the risks of vitrectomy as infection, bleeding, a torn or detached retina, poor vision, cataract, and increased pressure inside the eye that can lead to glaucoma, and notes cataract is especially likely in people over the age of 502. MedlinePlus lists bleeding, a detachment that is not completely fixed and may need more surgery, increased eye pressure, and infection6. Most are found at routine checks rather than announced by pain. Cataract in particular is painless, showing up months later as gradual blurring.
The honest population picture is this. Discomfort is common early, mild for most, and much reduced by two months, with a minority still noticing grittiness and dryness3. Nobody can promise a particular comfort level or date, since that depends on the operation, your eye beforehand, and your own healing. What can be said is that worsening pain is not the expected path.
When to Call, When to Wait, and Who to Contact
Severe pain, pain climbing over 24 to 48 hours, pain your medication no longer controls, a fresh drop in vision, thick discharge, or pain with nausea all justify a same-day call. The Academy's rule is simple: get in touch straight away if eye pain keeps getting worse after surgery, an injection or an injury1. You will not be thought a nuisance for calling. Retina teams keep unscheduled slots for exactly this.
Some things are not emergencies but should not wait for the next appointment. A stitch that catches with every blink, drops that sting so much you avoid them, pain that has plateaued after the first week, and posturing pain you cannot manage all belong here. Most are fixed by a small change: removing a stitch, switching a drop, or adjusting your posturing plan.
Mild grittiness, occasional watering, a dry eye first thing, and brief twinges weeks after surgery can usually wait for your scheduled review. Write them down when they happen, since they are easy to forget once you are in the chair.
Use the number on your discharge sheet first, since it usually reaches the on-call eye team rather than a general line. Keep it in your phone, and make sure whoever helps you at home knows it. If you cannot reach anyone and the pain is severe or your vision is dropping, go to an emergency department with eye cover rather than waiting for morning.
Common Questions About Pain After Retina Surgery
Yes, and it is common. In the study of 87 people after vitrectomy, fewer than half reported any pain even on the first day3. A comfortable recovery does not mean the operation did less work, or that something was missed. Your follow-up appointments, not your comfort level, tell your surgeon whether the retina is settling. Keep every one even if you feel entirely fine.
Movement pulls on tissue handled during surgery, and on the eye muscles if a scleral buckle was placed. That gives a distinct ache at the end of the eye movement rather than constant pain. It usually eases over the first weeks as swelling settles. Tell your team if it is severe, is not improving, or comes with double vision, since that combination is worth examining rather than waiting out.
Often genuinely uncomfortable. In the trial of 45 people, those on standard care rated day-of-surgery pain at an average of 5.64 out of 10, and scores were much closer between the groups by the first and seventh days5. That matches what many describe: a rough first evening, then a clear step down. Plan a quiet first 24 hours at home, and have the pain relief you were prescribed before you leave.
The bubble does not usually hurt on its own, but it can push the pressure inside the eye up, and that does hurt. Pressure pain tends to feel like a heavy brow ache, sometimes with nausea, which is one reason the early visit checks pressure. The bubble also brings a strict travel rule: no flying, no mountains, no scuba diving until it is gone2. Ask when your own bubble is expected to clear.
Often the drops. Several are used at once after retina surgery, some sting briefly, and preservatives can irritate a surface that is already dry. A sting lasting seconds and then settling is usually the drop. Pain that builds over minutes after each dose, or redness worsening, is worth reporting. Never stop a prescribed drop on your own, since some are doing the work of controlling swelling and lowering infection risk.
More Questions About Recovery and Discomfort
For most people it fades over the first few weeks. In the 87-person study, about a quarter still reported foreign-body sensation and dryness at two months3. A scratchy eye at that stage is not unusual, and not a sign of failure. Lubricating drops often help, but check which ones suit you, since some over-the-counter products are not ideal alongside your prescribed drops.
It is among the most common complaints of the posturing weeks, and says nothing about how the eye is healing. A randomized trial found a taught stretching program lowered median neck, shoulder and lower back pain on day three compared with usual care8. Ask your team which stretches and supports are safe for your posturing plan, and about cushions or a rented face-down chair.
Yes, and it deserves the same assessment as early pain. Late causes include a loose stitch, a rise in pressure, inflammation flaring as drops are tapered, and dryness. Late infection is uncommon but not impossible. Because you cannot tell these apart at home, treat new or worsening pain after a comfortable stretch as a reason to call rather than something to wait out.
No. Pain and anatomical success are not closely linked, and a sore recovery can follow an operation that went exactly as planned. Buckle surgery is typically sorer than small-gauge vitrectomy because of what it involves. Whether the retina is attached is answered by examination and imaging at your follow-up visits, not by how your eye feels this week. Worsening pain still needs checking on its own terms.
- Which operation did I have, and how sore is that one usually in the first week?
- What level of discomfort would you consider normal for me at one week and at one month?
- Which painkillers are safe with my other medicines, and which should I avoid?
- Do I have stitches, and when should they stop rubbing?
- Do I have a gas bubble, and when do you expect it to be gone?
- Which stretches or supports are safe for my posturing plan?
- Which number do I call at night or at the weekend?
- Which specific symptoms would make you want to see me the same day?
- American Academy of Ophthalmology, EyeSmart (2024). Common Types of Eye Infections: Symptoms and Treatment.
- American Academy of Ophthalmology, EyeSmart (2026). What Is Vitrectomy?.
- Clinical Ophthalmology (2015). A prospective study on postoperative discomfort after 20-gauge pars plana vitrectomy.
- Cureus (2025). Incidence and Risk Factors of Elevated Intraocular Pressure Following Vitrectomy Surgery in Rhegmatogenous Retinal Detachment in a Tertiary Hospital in Northern Malaysia.
- Ophthalmic Surgery, Lasers and Imaging Retina (2023). Efficacy of Perioperative Intravenous Dexamethasone on Postoperative Analgesia in Scleral Buckle Surgery: A Randomized Clinical Trial.
- MedlinePlus Medical Encyclopedia, A.D.A.M., U.S. National Library of Medicine (2024). Retinal detachment repair.
- PLOS ONE (2018). Incidence, microbiology, and outcomes of endophthalmitis after 111,876 pars plana vitrectomies at a single, tertiary eye care hospital.
- Scientific Reports (2021). A structured exercise to relieve musculoskeletal pain caused by face-down posture after retinal surgery: a randomized controlled trial.