Strabismus Surgery

ADULT AND PEDIATRIC STRABISMUS SUGERY

For adults and children, eye muscle surgery (strabismus surgery) is often recommended to re-align the eyes.  This procedure is performed under general anesthesia.

CHILDREN’S STRABISMUS SURGERY:

The procedure is performed at Alberta Children’s Hospital as a day procedure.  You will bring your child into the hospital on the day of surgery and go home the same day.  You cannot have your child not eat or drink for at least 6 hours prior to the procedure.

ADULT STRABISMUS SURGERY:

The procedure is performed at either Rockyview General Hospital or a non-hospital surgical facility.  The location of surgery depends on your general health.  The surgeon will let you know during the appointment which facility will work best for your case.  You will not be able to eat or drink at least 8 hours prior to the procedure.

WHAT SHOULD I EXPECT BEFORE, DURING, AND AFTER STRABISMUS SURGERY?

The procedure takes approximately 20 – 30 minutes per eye muscle and a typical surgery involves 2 eye muscles.  The eyes will feel uncomfortable, often like there is sand in the eyes, for approximately 2-4 days.  The eyes will be very red for 1-2 weeks, and then fade to white within 3-4 weeks following surgery.  The only restriction after surgery is no swimming for 1 week.

The eyes are often more straight right after surgery, but the final alignment often takes 4-6 weeks to see the final outcome.  It can be normal for older children to have double vision in the first week or two as the eyes are healing.  This often goes away on its own.

The surgery is performed by placing an eyelid speculum in the eye.  The surgeon will then make a small cut on the conjunctiva (the skin layer on the eye surface) and find the eye muscle on the surface of the eye.  A suture (stitch) is used to hold onto the muscle.  The muscle is then cut off the of eye surface and sutured (stitched) back to the eye surface in a different location.  The location varies depending on which type of eye misalignment your child has.  The small cut on the conjunctiva is then closed, eye ointment is placed in the eye and the speculum is removed.

Following surgery, you will be asked to use eye ointment in the surgical eye(s) four times a day.  This helps resolve the uncomfortable sandy feeling in the eyes.  You can run the eye ointment under warm water for a few seconds to make is easier to get into the eyes.  If this is too difficult, you can use the eye drops instead of the eye ointment four times daily.

The ophthalmologist will schedule a follow-up after surgery to assess how the eyes healed and to assess the eye alignment.

WHAT ARE THE RISKS OF STRABISMUS SURGERY?

General anesthesia (heart problems, lung problems, allergy to medications), over-correction, under correction, need for another surgery, double vision, infection, bleeding, need for glasses/prisms post-operatively, perforation of eyeball, eyelid drooping, pain, damage to other tissues, loss of vision or eye.

The American Academy of Pediatric Ophthalmology and Strabismus has further details.  Please see their website for further information.