STRABISMUS SURGERY

General Information

DEFINITION--Surgery to strengthen or weaken the muscles that regulate horizontal movement of the eyeball (see Strabismus in Illness section). The surgery will vary with the extent of the deviation of the movement and may be done in more than one operation.

BODY PARTS INVOLVED--Eyes.

REASONS FOR SURGERY--Realign the eyes to restore single binocular vision and a balance in the appearance of the eyes. The procedure is usually performed in children while the eye is still developing to save vision in the affected eye. In adults, the surgery is for cosmetic reasons only.

SURGICAL RISK INCREASES WITH

• Known drug allergy.
• Poor nutrition.

What To Expect

WHO OPERATES--Ophthalmologist.

WHERE PERFORMED--Hospital, outpatient surgical facility.

DIAGNOSTIC TESTS

• Before surgery: Special eye examinations to determine the amount of deviation. Tests performed will depend on the age of the patient (infant or an older child who can cooperate with instructions for visual testing).
• After surgery: Eye examinations may be repeated as necessary.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• The head is wrapped in sterile towels, leaving the eyes exposed.
• The eye muscle is exposed by cutting through the conjunctiva and fascia and a special instrument (called a squint hook) holds the whole width of the muscle.
• If the muscle is to be lengthened, it is cut close to its root and reattached with non-absorbable stitches to the surface layers of the eye at a distance determined by the initial tests.
• If the muscle is to be shortened, it is cut close to its root and a section is removed. The two ends are then stitched together.
• The fascia and conjunctiva are closed with stitches.
• A pad or shade may be placed on the eye.

POSSIBLE COMPLICATIONS

• Inflammation of the conjunctiva.
• Surgical-wound infection (rare).
• Bleeding.
• Repeat surgery if further correction required.
• Swelling of the eyelid.

AVERAGE HOSPITAL STAY--0 to 1 day.

PROBABLE OUTCOME--Expect complete healing and improved appearance without complications. Allow about 2 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• Bathe and shower as usual.
• Use a warm compress to relieve any pain, swelling or discomfort.

† You may use non--prescription drugs, such as acetaminophen, for minor pain. Avoid aspirin.

ACTIVITY

• Rest until the effects of the anesthesia wear off. The eye may water and be sensitive to light at first.
• Most normal activities can be resumed in about a week. Avoid swimming for 10 days.

DIET----No special diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.