Table of Contents - This Web Page
-
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.
Illustration of the six extraocular eye muscles.
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 (approximately 1/4 inch) 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 where there is no visible scarring of the eye surface as a result of this surgery.
When strabismus surgery is recommended, the earlier in life it is done the better the chance of your child achieving normal binocular vision.
Despite having the appropriate surgery, some patients may require further eye muscle surgery in the months or years following their initial operation to further refine their ocular alignment.
Before and after (one year later) strabismus surgery in child with congenital esotropia. 
-
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 is usually mild and can be controlled with Tylenol.
Photograph of child in recovery room following strabismus surgery two hours ago. This child had an esotropia. The ocular surface redness slowly resolves over the course of two weeks.
In the days following the operation, 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. In the first week or so after surgery, it is not unusual for the eyes to deviate in or out resulting in double vision. The final result of the operation may not be known for six weeks. -
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 possible 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 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.