What is Strabismus?
Strabismus (eye misalignment) can begin gradually over the course of months or years or can appear suddenly after an injury, illness or stroke. Adults often have double vision along with the strabismus that can be quite debilitating while children are usually able to suppress the vision from one eye and prevent double vision. Strabismus is treated with both surgery and prism glasses and sometimes does not require any treatment. Prism can be incorporated into glasses or can be applied as a sticker onto glasses when needed temporarily. Pediatric ophthalmologists specialize in strabismus or eye muscle surgery and perform these surgeries on both adults and children. Surgery is considered when the eye misalignment is causing bothersome double vision or when the appearance is bothersome to the patient.
Surgery FAQs
What happens during the surgery?
There are 3 pairs of eye muscles that control the movements of the eye (horizontal, vertical and torsional). The surgery is performed on the pair of eye muscles responsible for the abnormal eye position. For example, if an eye is turned inwards, the muscle that turns the eye in would be weakened (loosened) or the muscle that turns the eye out would be strengthened (tightened). The surgery involves small incisions into the conjunctiva, a clear layer covering the ‘whites’ of your eye (sclera). There is no incision into the eyeball itself.
How long does the surgery take?
Surgery generally takes about an hour but is scheduled for longer since it takes time to perform and reverse anesthesia.
Will I be awake for the surgery?
No, eye muscle surgery is performed under general anesthesia.
Will you do surgery on one eye or both?
It depends on the individual case- if one eye tends to be the misdirected eye or has poorer vision, we prefer to limit surgery to this affected eye.
Can I wait until my child is older to have the surgery done?
The best and longest lasting surgical results occur in young children who still have the ability to develop stereovision (3D vision) so if your child has an eye that is misdirected the majority of the time it makes sense to treat this as soon as possible.
What will I look like and feel like after surgery?
Your eyes will be red and irritated and often have a red splotch in the area of the surgery. The covering (conjunctiva) over the white of your eye will have several small dissolving sutures that feel like an eyelash in your eye. The blood spot will shrink and fade over the course of about 2 weeks and the sutures can take up to 6-7 weeks to completely dissolve but they become finer and less irritating over time. It is not advisable to schedule surgery within 1-2 months of a photographed event.
How long will I be out of school/work?
We advise patients to plan to be out of work for one week but people can often return to work after 3-4 days.
Are there any activities I cannot do after surgery?
No swimming for 2 weeks after surgery and no contact lens use for about 1 month after surgery.
Will I have to take medications after surgery?
You will use an eye ointment with both an antibiotic and steroid to use after surgery twice a day for at least the first week. Adults are given pain medication and anti-nausea medication as well.
Will you take my eyeball out of the socket?
Absolutely not. Your eye is attached by the optic nerve and cannot be removed from the socket.
What is an adjustable suture?
In cases that have a precise target (often vertical double vision) or in cases that are less easy to predict because of past eye muscle surgery or abnormal eye muscles (for example thyroid eye disease), it is helpful to use an adjustable suture reattach the eye muscle after surgery. The patient is then allowed to awaken in the recovery area and the suture can be adjusted (tightened or loosened) to straighten the eye and ensure no double vision.
