Correcting Strabismus through Eye Muscle Surgery

Squinting is habit common to many people. In many cases, it is a symptom of strabismus, a condition in which one eye cannot obtain binocular vision with the other due to a muscle imbalance of the eyeball. Strabismus is frequently corrected through eye muscle surgery.

However, eye muscle surgery is, more often than not, a COSMETIC cure; that is, surgery is performed to make the eye look straighter (not turned down, up or to one side). Since eye muscle surgery is usually not a FUNCTIONAL cure, where the afflicted eye is MADE to work with the other eye, the strabismus can return.

Candidates for Eye Muscle Surgery

There is generally no age restriction on candidates for eye muscle surgery, and it is often performed on children. However, it is recommended that individuals with conditions such as a fibrous band or a nerve palsy of the eye muscle do not undergo this type of surgery.

Procedure

Eye muscle surgery is typically performed as an outpatient procedure. Children are given general anesthesia, while local anesthesia is usually sufficient for adults.

The first step is to separate the eye muscle from the eyeball. Measurements are taken beforehand to determine the degree of muscle disparity. If the eye muscle needs to be tighter, part of it is removed or tucked before it is reconnected. Eye muscle surgery uses stitches that need not be removed.

Post Surgery

Patients are taken to the recovery room after surgery and vital signs are monitored. When patients encounter nausea, medication is administered. Many patients also require painkillers to lessen any pain and soreness.

Patients can usually go home within the day and eye drops or ointment is prescribed to avert the development of infection and swelling. Doctors require that patients come back for follow-up consultations, during which the new position of the eye and the healing process are observed.

Sometimes, when the patient develops poor vision, additional treatment is necessary. This treatment can include eye exercises, eye drops, a patch on the healthy eye, or the use of corrective eyewear.

Disadvantages

Research has shown that the highest success rate for eye muscle surgery is 11%, which includes BOTH cosmetic and functional cure, where the eyes do not only APPEAR straighter but binocular vision is also recovered or developed. If the condition returns, as it does in majority of patients, then repeated eye muscle surgery is required.

Eye muscle surgery also has a death rate. In America alone, over 20 deaths occur annually during the procedure. The deaths are caused by ocul-cardiac reflex, the same reflex that causes the pulse to slow down when pressure is exerted on the eye. When a patient is under anesthesia, this can result in cardiac arrest.

Vision Therapy – A Great Alternative…

For those who feel that eye muscle surgery is simply too risky, there is the option of optometric vision therapy.

Vision therapy has a success rate of 73% to 78%, based on studies. Furthermore, strabismus was corrected cosmetically AND functionally; that is, patients became truly binocular, and were able to use both eyes TOGETHER, keeping them straight under any condition.

Vision therapy is not a set of exercises designed to make the eye muscle stronger, because a weakened muscle is not what normally causes strabismus, as is the common misconception.

What vision therapy does is to help the patient unlearn the faulty manner in which he teams his eyes. Faulty habits are broken down and adaptations made to eliminate the problem. The patient is taken through the steps a child should go through to learn normal eye teaming. The process usually takes three months to one year, depending on the extent of the problem.