Patching the eye after surgery is a matter of routine. The eye patch is usually worn only overnight and then removed for the rest of the post-operative period. It can offer protection, reduce discomfort, but really has no “healing” attributes.
The Lid Should be Closed Against the Eye
A properly placed eye patch, for any reason, should be a “pressure patch,” meaning that the taped patch should exert enough pressure on the eye to keep the lid closed. This also ensures that the eye can not rub against the patch itself.
Whatever “discomfort” (doctor language for pain) there might be after the operation is decreased by blocking light. While the eye is still able to move underneath the closed lid, there is some additional comfort created by decreased blinking.
The cornea is a very sensitive tissue. Small abrasions can cause great sensitivity to light. Corneal abrasions, even those unrelated to surgery, usually heal rapidly, with or without patching.
The eye is dirty, so there is no protective effect from the patch, unlike, say, a true bandage. Remember that the eye, nose and mouth are all connected.
In the old days, when cataract surgery required a “large” incision to be made into the eye, a shield was placed on top of the patch. This shield would offer physical protection until the incision healed and became stronger.
There are a few special situations where patching is important after eye surgery. Occasionally the surgical wounds are not tightly sealed (i.e. the eye is leaking) and an additional day or two of patching is required. If patching doesn’t suffice, then a short trip back to the operating room might be warranted.
What Does This Mean? As surgical techniques have advanced, there is less tissue damage from surgery, that is, there is less cutting that causes trauma to the eye. Hence, there is really little discomfort after surgery.
Many cataract surgeons often have the patch removed later in the day so post-operative eye drops can be started right away. I’ve even heard of a few surgeons that forget the patch all together.
I still prefer to patch. I find it very useful to help limit swelling after placing a scleral buckle for retinal detachment, but I don’t find it mandatory for the reasons above.
An eye patch does serve as a reminder that an operation was performed and, I believe, are expected.