Alternative Names strabismus surgery, muscle imbalance surgery
Definition Eye muscle surgery is done to correct the position of the eyes. The goal is to make the eyes appear straight rather than turned inward, to the side, up or down.
Who is a candidate for the procedure? This surgery can be used to treat almost anyone, regardless of age, who has an incorrect alignment of the eyes. However, some unusual conditions are better handled with other treatments. These include a fibrous band in the place of the eye muscle or a nerve palsy of the eye muscle.
How is the procedure performed? Surgery on the eye muscles is commonly done on children. General anaesthesia is needed in these cases. Adults can often tolerate having the procedure with only local anaesthesia. The procedure is almost always done on an outpatient basis in a same day surgery setting.
Before surgery is started, precise measurements are taken to gauge the degree of muscle imbalance. This determines how much surgery is performed on the eye muscles. The first step in the operation is to detach the eye muscle from the side of the eyeball.
The muscle is then reattached at a new position. The stitches that are used do not have to be removed after surgery. If the muscle needs to be tightened, a portion of it is removed or a tuck is made before it is reconnected to the eyeball. After surgery on the eye muscle is complete, the mucous membrane layer that covers the muscle is put back into place. It, too, is also secured with stitches that dissolve over time.
What happens right after the procedure? After the surgery, the person will be taken to the surgery recovery room to be watched closely for a short time. Vital signs, blood pressure, pulse, and breathing will be checked frequently. Occasionally the person may feel nauseated after eye surgery. Medication will be given to control the nausea. Analgesia may be needed for discomfort. An eye patch may be applied following surgery.
What happens later at home? Most people are able to go home later in the day following surgery. Eye drops or ointment may need to be applied to prevent swelling and infection in the eye. At follow up visits, the eye doctor will check the person's vision, evaluate the new position of the eyes, and monitor healing. When poor vision in one eye, called amblyopia, accompanies muscle weakness, additional treatment after the surgery is needed to correct this problem. This may include drops, a patch on the eye with good vision, eye exercises, or glasses.
What are the potential complications after the procedure? There are complications with any surgery or anaesthesia. These include bleeding, infection, and reactions to the anaesthesia drugs. The eye muscle may be over or under corrected. Surgery may have to be repeated.
Author: William Stevens, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 5/02/2005 Contributors Potential conflict of interest information for reviewers available on request
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