My amazing partner (49yo M) is legally blind, sees only 5% with his left eye. His right eye has a long history of retinal detachments, is not his dominant vision eye and is mainly useful for receiving light.

Question and then the back story for more info:

Question:
If you have had (or live with someone who has had) the silicone injection for a retinal detachment and had to lay face level with the floor for two or three weeks, what was your post-op experience when you started being upright again? Any advice would also be appreciated.

Back story:
He started wearing glasses at 16 months old. Since he was a small child he has had 31 operations, mostly for retinal detachment on his right eye related to a progressive high myopia. He also has had bilateral cornea transplants and bilateral cataract surgeries with prescription lenses implanted to reduce the thickness of his external reading glasses. He also has a right eye scleral buckle and many right eye laser repairs/scars for retinal detachments.

Recently, he experienced a right eye retinal detachment. He saw a dog face shaped shadow mid-line towards his nose.

Upon assessment by the retinal specialist, it was found to be a vitreous leak that caused a separating of the retinal layers near some old scar tissue. He underwent a vitreoretinal surgery using a transconjunctival approach to perform the vitrectomy and repair the vitreous leak. Some scar tissue was also removed, which may improve the amount of light entering his right eye. At the end of the surgery, silicone oil was injected into the retinal space to ‘plug’ the holes. We are hopeful for a positive outcome. At some point, he will need the silicone removed since it can cause corneal graft failure (not cool ever, but especially now with Covid). Corneas are hard to find now.

The retinal specialist instructed him to lay face down for three weeks, 24/7 except for eating/showering and prescribed a host of eye drops. Afterwards, we have had three follow up appointments in 12 days because his IOP went up to 40. Turns out that he is highly sensitive to the steroid drops. With some changes to his meds, his IOP is back down to 16. Many of the medications will be tapered off soon.

Our appointments require us to travel 4 hours, one-way to the city. We also cross over a mountain pass that takes us up to ~10,000 feet above sea level. We reside at a mile high and the eye specialist’s office is roughly a mile high as well, so we make a big change in altitude during the journey. During our last car ride, he wasn’t able to keep his head level with the ground as much and while at the 10,000 feet level of the trip, he experienced a new blacked out area in his visual field on the side of his incisions. We were close to home, so he rested that night at home and in the morning it seemed to have resolved itself. He no longer noted the blacked out spot by morning. His sclera had some extra redness, so maybe it was another increase in IOP at that highest altitude causing the issue.

He has been super compliant with the eye drops and laying face down on my massage table, using the head cradle to create the horizontal position prescribed.

The retinal layers have stayed attached post-op. We go back in two weeks for follow up.

The doctor is optimistic, and so are we. Any experiences and tips with this that you share would be appreciated.