While most often done in children, eye muscle surgery is also done on adults.
It may be performed on one or both eyes and can prevent certain long-term vision problems.
Most people recover from surgery without complications.
However, multiple surgeries are sometimes necessary to correct an eye that continues to deviate.
This article explains what eye muscle surgery is and the potential risks that may come with it.
It also covers how to prepare for eye surgery, and what to expect from your recovery.
What Is Eye Muscle Surgery?
Eye muscle surgery is an outpatient procedure.Local anesthesiaorgeneral anesthesiacan be used for pain control.
Sometimes more than one surgery is needed, and each procedure may be scheduled at a different time.
Purpose of Eye Muscle Surgery
Each eye has six muscles that move it.
They are located toward the back of your eyeball and distributed on the sides, top, and bottom.
The pupils of the eyes can appear to be off-center.
And sometimes, the eyes may bulge or move involuntarily.
Strabismus is the most common reason for eye muscle surgery.
Parents and children may also become concerned about the appearance of their eyes from a cosmetic standpoint.
Contraindications
This surgery isn’t right for everyone.
If the eye is infected or injured, eye muscle surgery can cause additional damage to the eye.
These problems must be resolved before proceeding with eye muscle surgery.
Potential Risks
Eye muscle surgery can cause complicationsdue to the anesthesiaor the procedure itself.
Pre-operative testing can includecomplete blood count (CBC),blood chemistry tests, and a chest X-ray.
Location
The surgery will be done in an operating room located in a hospital or surgical center.
What to Wear
There are no specific wardrobe recommendations for this surgery.
Hair should be free of styling products and pulled back so it is not near the eyes.
Food and Drink
you better abstain from food and drink the night before getting general anesthesia.
If your child is young, the timing may be adjusted.
Your child’s anesthesiologist will give you more specific instructions.
Adults should have someone to drive them home after surgery because vision can be temporarily impaired after the operation.
A significant infection like a cold or flu will probably lead the medical team to reschedule the surgery.
If you are sick, inform them prior to arriving to discuss the best course of action.
Same-day blood tests can include CBC and electrolyte tests.
An intravenous (IV, in a vein) line will be placed in the arm or hand.
Before beginning the surgery, your ophthalmologist might also place antibiotic ointment on your eye.
During the Surgery
Eye muscle surgery should take about 30 to 60 minutes.
The next step is for your ophthalmologist to locate the muscle or muscles that need repair.
The muscles are directly visible through the conjunctival incision without the aid of a camera.
After the muscle properly positioned, the incision that was made in the conjunctiva is repaired with absorbable sutures.
The anesthesia is stopped.
After the Surgery
Close monitoring is necessary after the surgery.
Antibiotic drops or antibiotic ointment may be placed in the surgical eye to prevent an infection.
Pain medication will be given as necessary.
Some experience mild nausea while general anesthesia is wearing off.
Ginger drinks or salty or bland foods (like crackers) can help.
The ophthalmologist will check the eye a few hours after the operation.
If there are no complications, you will be sent home.
You will receive instructions about eye care and making a follow-up appointments.
Additionally, you will be given a list of signs of complications to look out for.
you could expect to see a visible improvement in eye deviation right after surgery.
Throughout the healing and recovery process, the eye will need to be kept clean to prevent an infection.
It may be necessary to wear a patch over the eye for the first few days after surgery.
A very small white bump may appear on the white part of the eye.
This is a suture knot and will eventually dissolve.
Sometimes the eye looks red for several weeks after surgery.
Generally, an over-the-counter pain reliever like acetaminophen can control mild discomfort.
If the eyelids appear swollen, ice packs may be applied.
Antibiotic-steroid eye drops may be given to prevent infection and help the eyes heal.
Use these drops as directed by your healthcare provider.
The eye that was operated on may begin to deviate after surgery, either due to over-correction or under-correction.
Usually, eye drops can help with this problem.
Possible Future Surgeries
Sometimes eye muscle correction requires multiple surgical steps performed in separate procedures.
In such a case, a subsequent surgery might be scheduled months after the first one.
And in some situations, post-operative eye deviation may require another eye muscle surgery for repair.
Summary
Eye muscle surgery, or strabismus correction surgery, is fairly common.
It’s usually done during childhood when an eye muscle is weak or has a structural problem.
Sometimes adults need this jot down of surgery, too.
Contact your healthcare provider with any concerns that may arise post-procedure.
American Academy of Opthalmology.Considerations in surgical correction of adult strabismus.
American Academy of Opthalmology.Adult strabismus surgery.
Tandon A, Oliveira C.Superior oblique myokymia, a review.Curr Opin Ophthalmol.
2019;30(6):472-475. doi:10.1097/ICU.0000000000000619
NYU Langone Health.Surgery for lazy eye.
Akbari MR, Mirmohammadsadeghi A, Mahmoudzadeh R, Veisi A.Management of thyroid eye disease-related strabismus.J Curr Ophthalmol.
2019;56(4):214-221. doi:10.3928/01913913-20190425-01
Kaiser Permanente.Blood thinners to avoid prior to surgery.
2019;27(1):1-5. doi:10.1080/09273972.2018.1561732
American Association for Pediatric Opthalmology and Strabismus.Strabismus surgery.
2018;22(1):7-11. doi:10.1016/j.jaapos.2017.09.004
