As important as eye muscle correction surgery for strabismus is, the postoperative recovery period is also important for maximizing the success of the procedure.
Strabismus is a pathology in which the focus is shifted sideways due to an imbalance of the muscles supporting the eyeballs. It is not only an aesthetic problem, but also affects the quality of vision. Later, images from the squinting eye are no longer perceived, and amblyopia – visual impairment that cannot be corrected with glasses – is added.
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Types of surgeries to correct strabismus
The aim of surgery to correct strabismus is to achieve optimum muscle fiber tension. If it is too long, it is shortened, and if it is short, it is lengthened.
There are the following types of surgeries to correct strabismus:
- Suturing the muscle to the sclera or tendon: the strength of the muscle depends on the place of attachment.
- Myectomy – muscle tightening is performed without overlapping the muscle.
- Removal of a part of the muscle fiber that provokes the change of direction of the eye.
- Creasing the muscle: adding creases or removing excess creases helps to regulate the strength of the muscle tension.
How is the surgery to correct strabismus performed?
The surgery takes no more than half an hour. After the surgery the bandage is put on the operated eye and not removed until the next morning. During the surgery the full immobility of the eye muscles is ensured. If the patient is an adult, he is given local anesthesia, but if it is a child, the surgery is carried out under general anesthesia.
The main steps of the surgery:
- A mask with slits for the eyes is put on the face.
- The eyelids are fixed with special spacers.
- The sclera is cut through, opening access to the eye muscles.
- The length of the muscle is corrected.
- Stitches are applied.
In cases where strabismus is quite severe, the surgery may be performed several times on adults and children.
More information about Eye Muscle Repair Surgery
Recovery and rehabilitation after strabismus surgery
The postoperative period can not be called difficult. At first there may be pain, swelling and redness of the eyes. In some cases there is a decrease in visual acuity, which subsequently recovers.
An adult patient can go back to work after just two days, in the most extreme cases the leave of absence is prolonged up to two weeks. After the surgery, it is important to protect your eyes from irritants. For example, you should not swim in swimming pools or natural water bodies or play sports. Damp cleaning is a good idea in the living room on a regular basis, since your eyes don’t react well to dust.
Within a few days after the surgery, the attending specialist will monitor the patient’s condition closely. Monitoring after general anesthesia should be particularly rigorous.
The patient or parents (if the patient is a child) will be given detailed instructions that must be followed during postoperative care. Moderate pain, itching in the operated eye, slight swelling of the upper and lower eyelids are normal.
The symptoms should disappear within 3 days.
Two weeks are usually enough for a full recovery. After that, adults can go back to work and children can go back to school.
During the first period, it is important to take precautions: you should not touch your eyes with dirty hands, you should avoid injuring your visual organs, etc.
It is also important to regularly take prescribed medication and visit the clinic: this will help speed up eye recovery and make rehabilitation after surgery safer. There are no special restrictions.
Within a few weeks, it is worth using anti-inflammatory agents in the form of drops: they should be used three times a day, one piece. If there are pus deposits on the eyes after a night’s sleep, you can rinse the eye with warm boiled water.
The first check-up examination is performed a week after the surgery to correct strabismus. During the check-up the specialist evaluates the healing process.
In order to assess the long-term effects of the surgery to restore the eyes, the eyes are checked 2 to 3 months after the correction. After that the specialist starts planning further steps in the treatment process.
Read also: Is Crossing Your Eyes Bad for You?
Possible complications
Usually, surgery to correct strabismus in children and adults passes without complications, but in rare cases they may occur. These include:
- double vision, which usually passes within 2-3 days;
- Painful sensations when moving the eyeballs;
- Swelling and redness of the eyes in the area of the stitches.
- It is worth noting that during surgery to remove strabismus affect the extraocular muscles: the retina and lens are not affected.
Let us consider in detail the possible complications:
- The development of infectious diseases, usually occurring in the early postoperative period. They occur quite rarely. For preventive purposes, antibacterial eye drops are prescribed. Infectious complications are detected during the first post-operative visit to the clinic. If there are pronounced painful sensations and swelling, it is necessary to immediately turn to a specialist.
- Perforation of the sclera. When the muscles are laced to the surface of the eye, the sclera can be damaged by a needle. Most often the result is a little bleeding. Extremely rarely, retinal detachment occurs or cryotherapy is needed. Today, modern needles are used for surgery to avoid such situations.
- A moderate decrease in visual acuity, which can develop due to changes in the shape of the eyeball. Wearing glasses or contact lenses may be prescribed to correct this defect.
- Complete loss of vision – this complication occurs very rarely, about one in ten thousand. It is provoked by endophthalmitis, retinal detachment or hemophthalmos. Fortunately, nowadays it is possible to timely notice the appearance of these pathologies and take corresponding measures for their elimination.
Sometimes patients confuse insufficient correction of strabismus with a complication. And this is wrong. After all, in this case a complete correction of the cosmetic defect can be achieved through several surgeries. To be fair, it is worth noting that such consequences of surgery are very rare. The effectiveness of the surgery can not always be 100% from the first time. Sometimes you have to resort to staged treatment to achieve the desired result.
Visually, the effect of the surgery is immediately noticeable: the squinting eye is back in place. If the surgery was performed not only to correct a cosmetic defect, but also to improve the quality of vision, surgery alone is not enough. Often the effect is fixed with hardware treatment.
The main purpose of the surgery to correct strabismus is esthetic: it is performed to restore the symmetry of the eye position.
However, to fully restore the functions of the squinting eye, one surgery is not enough: it is important to use a complex approach. The surgeon chooses the method of eliminating the defect during the surgery. This cannot be done beforehand, since the choice depends on the peculiarities of the eye muscles, which are individual for each individual patient.
In some cases, surgery to correct strabismus is performed on two eyes. It is important to bring the muscle responsible for the deviating eye into the right position. After the surgery, the patient does not need to wear prismatic glasses, which are very uncomfortable.
They are often the reason for prescribing surgery. Surgery can significantly improve the quality of life, remove the cosmetic defect and psychological problems caused by it, get rid of embarrassment, and restore emotional balance.
How dangerous is strabismus surgery
Even the simplest eye surgery implies certain risks. There are risks in this case too. The most common problem is double vision, which in some cases may not go away even after the rehabilitation period. To get rid of it, the doctor prescribes wearing prismatic glasses.
Other consequences of surgical intervention include retinal detachment, infectious diseases, anesthesia-related problems, and deterioration of vision quality.
The patient’s general state of health is important: the better it is, the more successful the surgery will be and the shorter the rehabilitation period will be.
In any case, don’t be alarmed beforehand. Medicine is moving forward, so negative developments are practically reduced to zero.
Do you need medical check-ups after the surgery?
During the first days after the surgery, the patient may feel discomfort, headaches, discomfort when tensing the eye muscles, the sensation of a foreign object in the eyes.
To eliminate the unpleasant symptoms, a specialist may recommend taking pain medication. Most often prescribed anti-inflammatory drugs: Naproxen – adults, “Ibuprofen” or “Paracetamol” – children.
After a few days, the patient’s condition improves, and he can return to his usual way of life. It is important to avoid overexertion.
As for hospitalization, its necessity depends on the general condition of the patient at the time of the surgery. Usually the surgery to remove strabismus is performed on an out-patient basis, and the patient returns to normal life within 2 days.
Full recovery takes about a week. Sometimes you may need a course of apparatus treatment which has a positive effect on the quality of vision and helps consolidate the results.
The vision recovers much longer. Eye exercises and various therapeutic procedures are used to speed up the process.
A strabismus surgery for eye muscle repair goes like this: while you are under general anesthesia (asleep and pain-free), a little cut is made in the tissue between the eye and eyelid (conjunctiva ). Several of the muscles of the eye are reinforced (resected) or compromised (recessed) to enable proper position and help the eye to move correctly. Typically, in adult surgery, an adjustable stitch will be used so that small modifications can be made later that day or the next day. After a couple of hours of recovery, you may go home. This technique generally provides an excellent outcome.
Hello, my child is 7 years old, one eye had a surgery, today is the second day after surgery, it hurts to open his eye, opens it for a few seconds and then closes it, I hardly drip. His eye is watering a bit. Is this normal or should I be worried?
You can see that your child has an early postoperative period. It is normal for the eye to react. The drops that you were prescribed: NSAIDs + Tobradex will reduce inflammation, remove redness. The only thing: You can put Corneregel behind your lower eyelid twice a day for a month. You can wear sunglasses outdoors to make it more comfortable to keep your eye open.