Sometimes we have seen cases where the eyes of small children or adults are not directed in the same direction. Some people also call this "strabismus". This condition, where one eye looks straight while the other eye turns in a different direction, makes some people feel embarrassed and makes it difficult to face society. But this is a medical condition that can often be treated and corrected. So the main and most successful solution to this is to straighten the eyes with a muscle surgery. We are talking about this surgery today, that is, Strabismus Surgery.
Simply put, what is Strabismus Surgery?
Strabismus surgery is an eye muscle surgery that is done to correct the position of your eyes, that is, to align them in the same line. Our eyes move back and forth, up and down, with the help of small muscles around them (eye muscles). So, in this surgery, the position of the eyes is corrected by tightening or loosening those muscles a little. Then, both your eyes get used to looking together, in the same direction.
Who needs this surgery?
About 5% of the world's population has this eye condition (strabismus). If your eyes are misaligned, meaning you have a squint, and other treatments, such as glasses, haven't helped, your eye doctor may recommend this surgery. This surgery is often performed on young children , but it can also be performed on adults .
This surgery may be necessary if the following conditions are present:
| Condition Name (Medical Term) | Simple explanation |
|---|---|
| Exotropia | One or both eyes to the side of the ears, that is, to turn outward . |
| Esotropia | One or both eyes are turned inwards, that is, towards the nose . (This is what many people call a 'squint'). |
| Hypertropia | Turning one eye upward relative to the other. |
| Hypotropia | One eye turning downward relative to the other. |
| Conditions caused by stroke | Sometimes, after a condition such as paralysis, eye control can be affected, resulting in this type of twitching. |
| Nystagmus | Uncontrollable rapid eye movements. Sometimes surgery is also performed for this. |
Are there any types of these surgeries?
Yes, this surgery can be done on one eye or both eyes. If it is done on both eyes, it is called ``Bilateral strabismus surgery.`` There are several ways in which the doctor manipulates the muscles in your eye.
- Resection: This involves cutting out a small piece of the eye muscle and shortening it . The muscle then tightens and pulls the eye to the other side.
- Plication: This is also a method of muscle tightening. However, here a piece is not cut out and removed. Instead, the muscle is folded and a stitch is placed on the outside .
- Recession: This involves removing the eye muscle from where it is attached to the eye, moving it back a little, and reattaching it . The muscle then relaxes and the eye turns to the other side.
Sometimes, especially for adults, "adjustable surgery" is performed. This means that after the surgery is over and you regain consciousness, the doctor can move the stitches in the eye muscle a little to further fine-tune the position of the eye.
What happens before the surgery?
Before the surgery, your doctor will ask you a few questions.
- Your complete medical history . This means your past and current illnesses, surgeries, etc.
- If you have had previous eye muscle surgery, talk to your doctor about that surgery.You will need to look at old reports (operative reports).
- You should tell your doctor about all medications and supplements you are taking, especially blood thinners .
- Have you or anyone in your family ever had any problems with anesthesia ?
- Do you have any allergies to any medications ?
You will meet with an anesthesiologist a few days before your surgery. He or she will tell you how long you should stop eating and drinking before the surgery. Usually, you will not be allowed to eat or drink anything from midnight the night before. You may also be asked to stop taking some medications for a few days before the surgery.
In addition, your eyes will be examined again before the surgery to confirm exactly which muscles need to be operated on.
What happens during the surgery?
There's nothing to worry about, this is a very safe surgery. Here's what happens during the surgery:
1. You will be given medicine through a vein (intravenously - IV).
2. All children and most adults are given general anesthesia. This means you will be completely asleep throughout the surgery and will not feel anything. Some adults may also be given a medicine that numbs only the eyes and makes them feel slightly drowsy.
3. The surgical team will continue to monitor your vital signs, such as your heart rate and breathing.
4. A special device (eye speculum) is used to keep your eye open.
5. The doctor makes a small incision in the thin membrane that covers the white part of the eye (conjunctiva).
6. Then, the muscle that needs to be operated on is grabbed with a special hook, lifted up, and any necessary changes (such as shortening or loosening) are made.
7. After making the necessary adjustments, the muscle is reattached to the eye with dissolvable sutures , and the incision is closed.
8. Finally, the device that held the eye open is removed and eye drops or ointment are applied to the eye.
This entire surgery usually takes about 30 minutes to two hours .
What happens after the surgery?
After surgery, you will be taken to a recovery room. The medical team will monitor your condition until you are ready to go home.
- A responsible adult will need to accompany you home. They will be asked to stay with you for 24 hours after the surgery.
- You will need to rest and avoid overexertion for a few days to a week.
- Eye drops or ointments prescribed by a doctorYou have to use it at the right time.
- For pain, they may tell you to take a painkiller like Paracetamol or perhaps Ibuprofen.
- Be sure to ask clearly about what to be careful of after surgery and when to talk to the doctor.
What are the benefits of having this surgery?
The main benefit of this surgery is the way your eyes work together, which means improved three-dimensional (3D) vision . This is especially important for young children.
While the eyeballs are aligned, your vision clarity will not change with this surgery. This means that if you wear glasses, you will still need to wear them after the surgery. However, many people say that they feel much more confident about their appearance after this surgery.
Are there any risks to this surgery?
Strabismus surgery is a very safe procedure , but like any surgery, there are some risks.
- Recurrence of the squint: Sometimes, after some time after surgery, the eyes may return to their old position or may deviate too much to the right.
- Infection: A germ can get into the eye and cause an infection.
- Bleeding: There may be minor bleeding.
- Allergies to medication or anesthesia: These are very rare.
- Diplopia: You may see things in twos for a few days after surgery.
- Scarring: A small scar may form on the white of the eye.
- Drooping eyelid (Ptosis): Rarely, the eyelid may droop slightly.
- Damage to the white part of the eye (sclera): This is also a very rare complication.
How long does it take to heal?
After the surgery, you will need to rest for a few days to a week or two. Your eyes will be red for a few weeks . You may also feel pain or a gritty feeling in your eyes. It can take 3 to 12 weeks for your eyes to fully heal.
Important:
- Don't drive until your doctor tells you to.
- Avoid swimming pools, saunas, or hot tubs for two weeks after surgery. This can help prevent infection.
What time do you want to see the doctor again?
If you have any of the following symptoms, call your doctor immediately.
| Symptoms to watch out for |
|---|
| If the eye pain is increasing day by day instead of decreasing. |
| If you feel like your vision is getting weak . |
| If you see signs of infection (e.g. fever, discharge from the eye, increased redness of the white part of the eye, swelling of the eyelid ). |
| If scar tissue or a red lump forms on the white part of the eye. |
| If you have any other symptoms that make you feel uncomfortable or suspicious. |
Some frequently asked questions
How long does it take to see two?
You may experience diplopia for a few days after surgery. In some people, it may last longer. If you have any concerns about this, talk to your eye doctor.
Can I get back into bed after surgery?
Yes, sometimes more than one surgery may be required to completely correct a squint. This is especially true for children who have surgery at a young age.
Do I need to wear glasses after the surgery?
Yes, you will continue to wear glasses. Strabismus surgery does not change your prescription or your vision clarity. It only corrects the position of your eyes.
Take-Home Message
- Strabismus surgery is a very safe and successful surgery to correct eye misalignment.
- This surgery can be performed on both children and adults.
- This not only corrects the position of the eyes, but also improves 3D vision and increases self-confidence.
- It is very important to follow the doctor's instructions exactly after surgery (especially the use of eye drops and rest).
- This surgery will not change your prescription. You will need to continue to wear glasses to maintain clear vision.
- If you experience any unusual symptoms after surgery, notify your doctor immediately.
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