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Eye muscle repair surgery is a procedure that corrects a muscle imbalance in the eyes. The muscle imbalance causes the eyes to cross inward or outward. This condition is known as strabismus. People with strabismus have eyes that don’t line up properly. As a result, the eyes look in different directions. It’s important to treat strabismus as early as possible to avoid lifelong vision problems. In fact, vision loss could become a permanent disability if treatment isn’t received promptly.
Eye muscle repair surgery helps realign the eyes so that both point in the same direction. This procedure is most often performed on children with strabismus, but it may also be done to help adults with eye muscle problems.
Some people successfully overcome strabismus by doing eye exercises or by wearing eyeglasses. Eye muscle repair surgery is a solution for those who don’t show improvement through nonsurgical means.
You will undergo a complete physical and eye examination before eye muscle repair surgery. The doctor will take note of any prior treatments used to fix your eye muscle problems. They will also take eye measurements and determine which muscles are weaker or stronger than they should be.
About seven to 10 days before your surgery, you will need to stop taking medications that can increase your risk of bleeding. Medicines in this category may include:
Make sure you tell your doctor about any other prescription drugs, over-the-counter medications, or supplements you may be taking.
Fasting before the surgery is often required to avoid adverse reactions to the anesthesia, such as nausea and vomiting. Your doctor will let you know when to have your last meal, based on the time of your surgery.
Children usually undergo eye muscle repair surgery with a general anesthetic. This puts them to sleep throughout the procedure so they don’t feel any pain. Adults who need eye muscle repair are generally treated with a local anesthetic that numbs the eye.
The surgeon will make a small incision in the clear membrane that covers the white of your eye. This membrane is known as the conjunctiva. Once the surgeon has access to the eye muscles, they will either shorten or stretch them as needed to properly realign your eye. The entire procedure takes about 90 minutes.
To shorten and strengthen the muscles, the surgeon will remove a section of the muscles or a nearby tendon. This process is called a resection. When the muscles need to be weakened, they are stretched and reattached to a point farther back in your eye. This is known as a recession.
Some people with strabismus require surgery in only one eye, while others may need to repair both eyes. One or more muscles in the eyes can be repaired during the same surgical procedure.
Excessive bleeding and infection are possible risks of any type of surgery. You can reduce your risk for heavy bleeding by following your doctor’s instructions regarding blood-thinning medications before the procedure. Keeping your incisions dry and clean will also help prevent an infection from occurring after surgery.
In rare cases, eye muscle repair surgery can cause double vision and eye damage.
Eye muscle repair surgery is usually an outpatient procedure, which means you can go home the same day as the surgery. Your eyes will probably feel scratchy and painful for several days after the surgery, but it’s important to avoid touching or rubbing your eyes. Keeping the eyes free of dirt and other irritants is of the utmost importance to prevent infection. Your doctor may prescribe antibiotic eye drops or ointments as a precautionary measure.
You will need to meet with your doctor about one to two weeks after your eye muscle repair surgery. By this point, you should feel more comfortable and your eyes should look normal.
In some cases, follow-up treatment may still be required for vision problems, as strabismus can lead to impaired vision in some people. Even though the eye muscles are corrected surgically, vision loss can remain. You will still need to continue wearing eyeglasses and contacts for vision problems, such as nearsightedness, farsightedness, or astigmatism.
Children who have poor vision as a result of strabismus may need to continue wearing an eye patch following eye muscle repair surgery. The length of time it must be worn depends on the severity of the condition. Eye patches are used when one weak eye leads to crossing. Patching the strong eye, even after surgery, helps stimulate the weaker eye. The patch also helps a child’s brain develop more fully in the area that manages vision. Your child may need to wear an eye patch for at least two hours per day to strengthen a weak eye.
Written by: Erica Roth
Medically reviewed on: Jan 26, 2016: Mark R. Laflamme, MD
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