Strabismus Surgery – Procedures

Strabismus surgery is a procedure to adjust (align) the eye muscles so that both eyes point in the same direction.

Strabismus is a condition in which the eye muscles do not work together to keep both of the eyes looking in the same direction. One eye is either turned in, out, up, or down.

During surgery, one or more eye muscles are shortened, lengthened, or moved so that the eyes line up.

Surgery may be done on one eye or both eyes, depending on the condition. Strabismus surgery is most commonly done for children, but it can also be done for adults.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or your family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Double vision.
• Reduced vision.
• Too much correction (overcorrection) or not enough correction (undercorrection) of the eye position.

If these problems occur, you may need glasses or another procedure.

What happens before the procedure?

Medicines

Ask your health care provider about:

• Changing or stopping you regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements. Do not take these during the week before your procedure unless your health care provider approves them.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• You will have an eye exam to determine which eye muscles need to be adjusted (sensorimotor exam).
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• Ask your health care provider what steps will be taken to help prevent infection. These may include:
  • Washing skin with a germ-killing soap.
  • Antibiotic medicine.

What happens during the procedure?

• An IV will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic). You may also be given medicine to help you relax (sedative).
• A surgical instrument (lid speculum) will be placed so that it holds your eyelids open.
• An incision will be made in the outer covering of the eye (conjunctiva).
• The conjunctiva will be opened above the area where the eye muscles attach to the eye.
• The muscle or muscles that need to be adjusted will be identified and lifted up with a tiny hook.
• The muscle(s) will be moved, shortened, or lengthened to align your eye. Stitches that dissolve over time (absorbable sutures) will be used to hold the muscle(s) in place.
• The incision in the conjunctiva may be closed with absorbable sutures.
• The lid speculum will be removed.
• Eye drops will be placed into your eye.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You will be given medicine for pain as needed.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• Do not drive until your health care provider approves.

Summary

• Strabismus surgery is a procedure to adjust (align) the eye muscles so that both eyes point in the same direction.
• During surgery, one or more eye muscles are shortened, lengthened, or moved so that the eyes line up.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic.

Strabismus Surgery, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Eye redness.
• Eye soreness and scratchiness, especially with movement.
• Double vision.

Follow these instructions at home:

Eye care

• If directed, put a wet, cool washcloth or towel (cool compress) over your eye to help relieve soreness and scratchiness.
• Do not rub your eye.
• Follow instructions from your health care provider about caring for the incision in your eye. The stitches (absorbable sutures) in the eye will dissolve over time and do not need to be removed.

General instructions

• Take over-the-counter and prescription medicines, including eye drops, only as told by your health care provider.
• Do not drive until your health care provider approves.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not swim or use a hot tub until your health care provider approves. This is usually about two weeks. You may shower as usual.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

• A fever.
• Redness, pain, swelling, or double vision that lasts for more than two weeks after the procedure.

Get help right away if you have:

• Redness, pain, or swelling around the eye that gets worse.
• Blood or pus coming from your eye.
• A sudden change in vision.

Summary

• After the procedure, it is common to have eye soreness and scratchiness, especially with movement.
• If directed, put a wet, cool washcloth or towel (cool compress) over your eye to help relieve discomfort.
• Do not rub your eye.