Surgical treatment that strengthens or relaxes the extraocular muscles to restore parallel alignment of the two eyes. Both functional and aesthetic benefits are targeted.
Indication
- Visible deviation in one or both eyes (inward, outward, upward, downward)
- Strabismus that does not respond to conservative treatment (glasses, prisms, patching)
- Eye misalignment causing double vision or an abnormal head position
- Strabismus persisting after the 6th month of age and requiring follow-up (surgery is usually considered between ages 4-6)
- Acquired strabismus in adults (nerve palsy, thyroid eye disease, trauma)
- Persistent strabismus cases with significant aesthetic and psychosocial impact
Preparation
- Comprehensive eye examination, measurement of the deviation angle, and visual acuity assessment
- Patients planned for general anesthesia must fast for 6-8 hours before the procedure
- Inform the physician of all medications, allergies, and previous surgeries
- Pediatric patients undergo a pediatric assessment before anesthesia
- Antiseptic eye cleansing is performed before the procedure
How it's performed
- General anesthesia is preferred for children; general or regional anesthesia for adults
- The eyelids are kept open and a small incision is made in the thin membrane (conjunctiva) over the white of the eye
- The targeted eye muscle (rectus or oblique) is hooked
- Depending on the direction of the deviation, the relevant muscle is recessed (relaxed) or resected (strengthened)
- The muscle is fixed in its new position with absorbable sutures
- The conjunctiva is closed; no skin sutures are needed, and the procedure usually lasts 30-60 minutes
Post-procedure
- Same-day or one-night-stay discharge is usually possible
- Antibiotic and corticosteroid drops are used regularly during the first 1-2 weeks
- Mild redness, watering, and a foreign-body sensation may persist for 2-4 weeks
- First check-up at week 1, followed by month 1 and month 3
- If amblyopia (lazy eye) is present, patching therapy may be continued after surgery
- Some cases may require additional intervention for residual deviation over time
Risks
- Under- or overcorrection (revision surgery may be needed)
- Risk of conjunctival or scleral infection (rare)
- Temporary double vision or restricted eye movement
- Anesthesia reactions (a particularly rare risk in children)
- Very rare scleral perforation and intraocular infection (endophthalmitis)
FAQ
At what age can my child have surgery?
In cases such as infantile esotropia persisting after 6 months of age, early surgery may be considered. Many cases are appropriate between ages 4-6, but the decision is made based on the angle of deviation and visual development.
Does strabismus surgery correct lazy eye?
No. Surgery corrects eye alignment; lazy eye (amblyopia) requires separate glasses and patching therapy. For this reason, both treatments are planned together.
Is full correction guaranteed in a single session?
Significant improvement is achieved in most cases, but full correction cannot always be guaranteed. Some patients may require additional intervention for residual deviation.
When can I return to normal life after surgery?
Children typically return to school within 3-5 days; adults can return to work within 5-7 days. Heavy sports, swimming, and exposure to dust or chemicals are restricted for the first 3-4 weeks.
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