Strabismus Surgery (Eye Misalignment Correction)

Strabismus is the medical name for eye misalignment – meaning the eyes point in different directions. While one eye looks straight ahead, the other eye turns outward, inward, upward, or downward. In some cases both eyes are affected. About 5 percent of children are affected by strabismus, commonly referred to as being “cross eyed” or “wall eyed”. Strabismus can also affect adults, either because it was not treated as a child, because of a stroke or a tumor, or with no apparent reason.

Strabismus should be corrected as it can lead to double vision. Correction may also lead to improved depth perception or binocular vision. And, of course, people often opt to have strabismus surgery due to the improvement in the appearance of eye alignment.

Eye muscle surgery is done as an outpatient at the hospital, most often under general anesthesia. Before the surgery, we take careful measurements of the eye position which enables us to determine which muscles to operate on, whether we will operate on both eyes, and how much we need to move the muscles to achieve good eye position after the surgery. Taking these measurements may involve several appointments, and we always take additional measurements a week before surgery.

We are very careful because the success rate of eye muscle surgery is not 100 percent. The success rate of eye muscle surgery is 60-80 percent. This means that on average, 7 out of 10 persons who undergo eye muscle surgery will achieve a good result with only one procedure. The remaining 3 persons may, at some point, be benefited by additional surgery for good eye position. The success rate of each surgery is always the same, 60-80 percent.

Strabismus surgery is a commonly performed procedure to correct the eye position. It does not require that the eye be “taken out” in order to reach the muscle. A small incision into the transparent covering of the eye (conjunctiva) is made to reach the muscle. The muscle is then repositioned and reattached with tiny sutures, and the conjunctiva is also closed with tiny sutures, which will dissolve by themselves over the next 1-2 weeks. Once the surgery is completed, you may go home after awakening.

It is very important that two weeks prior to your surgery you should not use any aspirin or “aspirin like” medicines. This includes medicines containing ibuprofen or naproxen such as Advil, Nuprin, Aleve, etc. Please use Tylenol only, if necessary.

Most patients spend several hours in the outpatient surgery area, and go home in the mid-afternoon if the surgery was done in the morning. In most cases there are no patches or bandages over the eyes following the surgery. Glasses, if worn, may be restarted after the surgery. Please remember to bring them with you on your postoperative visit.

After the surgery, the eyes will be quite red in the areas where the surgery was done, and may have jelly-like swelling. This is normal and will clear over the next few weeks. Sometimes the redness spreads before clearing, but do not be alarmed. Antibiotic drops will be prescribed for use after the surgery, and will be used for 5-7 days. The discomfort following eye muscle surgery is usually minimal with a foreign body sensation in the eyes or some discomfort on movement of the eyes for several days. Pain medicine is usually not necessary; however, you may use Tylenol as needed. Some people may experience transient double vision after surgery. This is a normal part of healing as the brain must “get used” to the new position of the eyes. The double vision is usually completely gone within a few days, but in some instances may last longer.

It is important that people who have had eye muscle surgery stick to “light physical activity” for 10 days following the surgery. Basically, this means no exercising, P.E., running or jumping, or heavy lifting for 10 days. After the 10 days it is fine to swim, preferably using goggles until the redness has gone away. We usually see patients who have had eye muscle surgery within the first few days postoperatively, then the next week, and 6 weeks postoperatively. The healing process is gradual, and will take the 6 weeks to be complete.

Your confidence in allowing us to care for you is highly valued. We are always available to answer your questions. Please let us know if there is anything we can do to make this time easier for you.