Strabismus Surgery
Eye muscle surgery, or "strabismus surgery", involves either increasing or decreasing the tension of the small muscles on the surface of the eye. These muscles move the eye in all directions.
The physicians at Pediatric Ophthalmic Consultants are all accomplished strabismus surgeons. We have a very large strabismus surgical service. We regularly operate upon patients from the New York Metro Region, other areas of the U.S. and abroad.
Strabismus Surgery
This type of surgery is typically performed in a hospital outpatient surgical facility. During the surgery the eye is never removed! Rather, a small incision is made on the clear membrane covering the white part of one or both eyes. Through this incision, the appropriate surgery is then performed on the surface of the eye to eliminate the strabismus. The inside of the eyeball is not entered during this type of surgery. Contemporary strabismus surgical techniques involve "hidden" incisions, leaving virtually no visible scarring of the eye surface as a result of this surgery.
When strabismus surgery is recommended for a child, the earlier in life it is done the better the chance of the child achieving binocular vision, or "depth perception".
Despite having the appropriate surgery, some patients may require further eye muscle surgery in the months, years or decades following their initial operation to further refine their ocular alignment.
Photograph of child in recovery room following strabismus surgery (two hours after surgery). This child had an esotropia. The tension of the inner muscle of each eye has been relaxed. The ocular surface redness slowly resolves over the course of two weeks.
Recovery & Restrictions Following Strabismus Surgery
Recovery from strabismus surgery is usually uneventful and smooth, however there are postoperative issues that can be anticipated. Some mild sleepiness may persist after awakening from anesthesia. Temporary nausea or vomiting is possible, however, very effective medications are generally given during the surgery to prevent this. Eating and drinking can be resumed as tolerated. If present, pain or irritation is usually mild and can be controlled with Tylenol.
In the days following the operation, redness of the operated eye(s) is expected. Mild crusting of the eyelids and blood-tinged tears may occur. An antibiotic eye drop or ointment may be prescribed during the first week. Generally, no restrictions on activity are required except that swimming should be avoided for two weeks. The outcome of the operation may not be evident for several weeks.
Before and after (one year later) strabismus surgery in child with congenital esotropia.
Adjustable Suture Surgery For Adults
As with children, adults who undergo eye muscle surgery can usually achieve precise surgical results with standard surgery. There are occasions, however, when such precision is not possible due to the underlying cause of the strabismus, such as scarring from old surgery, inflammation from eye muscle diseases, or neurological weakness. In these cases, it is sometimes advisable to adjust the tension of the muscles postoperatively.
In adjustable suture surgery, the surgery is performed under general anesthesia in the typical fashion except that temporary suture knots are placed. Several hours after awakening from anesthesia, the eye alignment is evaluated. If it is good, permanent knots are tied. If the eyes are not adequately aligned, an adjustment in the muscle tension can be performed. These final steps are completed with the patient awake and the surface of the eye anesthetized with eye drops. When appropriate, this technique can enhance the surgical outcome.