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What is strabismus (squint) surgery?

Strabismus surgery loosens or tightens some of the eye muscles, which changes the alignment of the eyes relative to each other.

How does the surgeon approach the eye muscles?

The eye muscles attach to the sclera (wall of the eye). The muscles are covered by a thin layer of transparent tissue called the conjunctiva. The eyelids are held open by a lid speculum. The surgeon incises the conjunctiva to access the eye muscle(s) and uses small instruments to isolate the muscle. No skin incisions are made. The eyeball is not removed from the eye socket during strabismus surgery.

What kind of anaesthesia is used for strabismus surgery?

The type of anaesthesia depends on patient age and health, as well as patient preference. Most children undergo general anaesthesia. The procedure will be performed at New Era Health Day Clinic. It is performed as an outpatient (patients do not stay overnight in the facility).

What are the risks of strabismus surgery?

Over- or undercorrection (turning the eyes too much, or too little) Need for additional surgeries to successfully align the eyes:

  • 70% success with 1 procedure
  • 80-90% success with 2 procedures

Severe complications: (1:400)
Perforation of the wall of the eyeball 1:1000
Infection around the eye 1:1500
Slipped or lost eye muscle 1:1500
Infection inside the eye causing vision loss (endophthalmitis) 1:24 000 Scar tissue formation with repeated surgeries

Other rare but significant complications include: persistent misalignment, limitation of eye movements, altered eyelid position or persistent visual problems - double vision, a dilated pupil and reduced accommodation (ability to focus for near).

Mild complications:

Temporary side-effects such as a corneal abrasion, conjunctivitis and eye ache.

Ocular surface problems such as a persistent red eye, chemosis (conjunctival swelling), haemorrhage (bleeding), pyogenic granuloma, Tenon’s fascia prolapse, epithelial inclusion cyst, dellen and a stitch granuloma.

Severe complications of general anaesthesia: 1:1 000 000

*NB Please ask Prof Tinley before the operation if you would like him to explain any of these to you in more detail.

Are the eyes red after strabismus surgery?

It is normal for the white part of the eyes to be red after surgery. It may take several weeks, or occasionally months for the redness to disappear. The eyes are usually scratchy and are sore upon movement. The soreness usually improves after a few days, depending on what surgery was performed.

Is medicine used after surgery?

All surgeons apply antibiotic/steroid drops or ointment at the end of the surgery. Some surgeons will prescribe a similar drop or ointment for a few weeks after surgery.

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“Vision is the true creative rhythm”

- Robert Delaunay