What you need to know about Strabismus Surgery

Are your eyes not looking in the same direction? Does it look like one of your child's eyes is slightly turned in or out? We usually call this "crossed eyes." This is not as scary as you might think. Most of the time, this condition can be controlled with glasses or other treatments. However, in some cases, the doctor may suggest a minor surgery. That's what we're going to talk about today. It's normal to feel a little scared when you hear the word surgery, but let's explain everything clearly and simply.

What exactly is Strabismus Surgery?

Simply put, this is a surgery performed on the eye muscles that help us move our eyes from side to side. Think of our eyes as two balls, held together by cords (muscles) on all four sides. If one or more of these cords becomes too tight or too loose, the eye will be pulled to one side. That's what strabismus is.

So, in this surgery, the doctor tightens or loosens those muscles as needed . Then both eyes come into the same line, straight. Then both eyes can come together and look at one thing.

Who really needs this surgery?

Strabismus is not as rare as you might think. About 5% of the world's population has this condition. If you have a strabismus in both eyes and other treatments, such as glasses, don't help, your eye doctor may suggest this surgery. This surgery is often performed on young children , but it can also be performed on adults .

See the table below for what types of conditions require this surgery.

Will the things done during surgery change?

Yes, there are several ways the doctor can correct the eye muscles. The method used will depend on your condition.

• Resection: This involves cutting out a small piece of the eye muscle and shortening it. This tightens the muscle.
• Plication: In this, the muscle is folded and sewn together , rather than cut. It's like folding and sewing a piece of cloth. Even then, the muscle shortens and tightens.
• Recession: This involves removing a muscle that is too tight from its attachment to the eye , moving it back a little, and then reattaching it . This causes the muscle to become less tight and looser.

In addition, sometimes a method called "Adjustable Surgery" is used. In this method, when you wake up after the surgery, the doctor can look at your eye and at the same time move something like a small knot around to further fine-tune the position of the eye.

What happens before the surgery?

After scheduling your surgery, your doctor will definitely ask you a few questions. It's important to be honest and tell you everything .

• Your complete medical history . This includes any other medical conditions you have (such as diabetes, high blood pressure), and any previous surgeries you have had.
• If you have previously had surgery on the eye muscles, those are the operative reports .
• You should tell us about all the medications and vitamins you are currently taking, especially blood thinners.
• Whether you or anyone in your family has had problems with anesthesia .
• Do you have any allergies to medications ?

Before the surgery, an anesthesiologist will examine you and tell you what time you should stop eating and drinking before the surgery. Usually, you will not be allowed to eat or drink anything after midnight the night before the surgery. Also, if you need to stop taking any of the medications you are taking, your doctor will tell you about that as well.

What happens during the surgery?

Even though you feel a little scared when you hear this, you don't really feel anything.

• The medical team will monitor your vital signs, such as your heart rate and blood pressure, throughout the surgery.
• A small device called an 'eye speculum' is used to keep the eye open.
• The surgeon then makes a very small incision in the thin membrane (conjunctiva) that covers the white part of the eye (sclera).
• Then, find the muscle that needs to be corrected and make the necessary changes (such as shortening or loosening) as discussed earlier.
• Finally, the incision is closed with dissolving sutures , so there is no need to go back and remove the stitches.
• Finally, eye drops or ointment are applied to the eyes, and the surgery is completed.

This entire surgery can usually take anywhere from 30 minutes to two hours .

What happens after the surgery and are there any risks?

After the surgery, you will be taken to the recovery room. The medical team will take care of you until you regain consciousness.

The most important thing is that you cannot go home alone. A responsible adult must accompany you home. You will need to rest for a few days to a week after the surgery.

The eye drops or ointment prescribed by the doctor should be used exactly on time. He may tell you to take medicine like Paracetamol for the pain.

• Recurrence of the squint: Sometimes the eyes may squint again in the same way as before, or they may deviate more than usual and turn to the other side.
• Infection.
• Bleeding.
• Double vision (Diplopia): This is normal for a few days after surgery. However, if it persists, you should tell your doctor .
• Scarring.
• Drooping eyelid (Ptosis).

Recovery time and precautions

After surgery, your eyes may be slightly red and feel scratchy. This redness may last for several weeks. It can take about 3 to 12 weeks for your eyes to fully heal.

Important instructions

• Do not drive until your doctor gives you permission.
• Avoid swimming pools, saunas, or hot tubs for two weeks after surgery. This can help protect against infections.
• You will need to continue using your glasses after the surgery. This surgery will not change your vision impairment (glasses prescription).

If something like this happens, see a doctor immediately.

• If the eye pain is increasing day by day instead of decreasing.
• If your vision is getting worse .
• If there are signs of infection (fever, pus-like discharge from the eye, increased redness of the white part of the eye, swelling of the eyelid).
• If something like a new lump forms above the eye.
• If you experience any symptoms that make you feel uncomfortable or suspicious .

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