“The Ultimate test of a relation is to disagree but still hold hands”
Sometimes two friends not only disagree, but also bid adieu to each other because they do not see eye to eye on a lot of things. This is literally what happens when our two eyes decide to part their ways. The condition is called strabismus. And what can be done to catch hold of these errant friends’ ears and bring them back on track? A procedure called squint surgery.
Strabismus or squint or crossed eyes is a disorder in which your eyes are not aligned properly and the two eyes do not look at the same object at the same time.
Each of your eyes has six muscles that control its movements. A squint may occur if a muscle is too strong causing your eye to turn in/ out/ up / down.
Weakness of an eye muscle (due to a problem with the nerves controlling it) can also cause abnormal turning of your eye.
Strabismus surgery is a procedure that is used to change the alignment of the eyes relative to each other by strengthening or weakening eye muscles.
The anesthesia used depends on your age, health condition and your preference. Children typically undergo the surgery under general anesthesia, which means that you are asleep the whole while. Adults may choose to have it under general anesthesia, or conscious sedation or local anesthesia where your eye is benumbed.
Squint surgery is done on an out patient basis, meaning that over night hospitalisation is not required. The surgery usually takes about 20 – 40 minutes.
Your eyeball is never removed from its socket and neither is the inside of your eyeball entered. Eyelids are held open by a samll instrument called the lid speculum. No cuts are made on the skin. The surgeon makes a small cut on the conjunctiva (transparent tissues covering the eyes) so that he can reach the eye muscles. The eye muscles are detached from the sclera (wall of the eye) and repositioned. The following types of repositioning are done:
In a recession procedure, the muscle is cut from the surface of the eyeball and is re-attached further back from the front of the eyeball. A stitch is placed through the muscle to hold it in place. This weakens the function of the muscle.
In a resection procedure, a portion of the muscle is removed and the shortened muscle is reattached to the eye. Here, the muscle is strengthened in its action due to its shortened length. A stitch is placed to hold the muscle at its intended location on the eyeball.
• Adjustable suture:
This surgery is done under general anesthesia. In an adjustable suture method, a bow knot or a slip knot is used which is a temporary knot as against a permanent knot in the standard strabismus surgery. Several hours after you have awakened from the anesthesia, the alignment of your eye is checked. If it is good, permanent knots are tied. If not, the alignment is changed by adjusting this temporary knot.
A change in alignment will be noticeable immediately after surgery, but the final effect can be seen to 6 weeks after surgery.
The white part of your eye remains red for 1-2 weeks or sometimes months after the surgery.
Your eyes may be scratchy and sore on moving them. This soreness will disappear after a few days.
Recovery is very rapid with this surgery. Patients usually resume their normal activities within a few days.
Despite having an appropriate surgery, you may still require further eye muscle surgery months, years or decades later to refine your eye alignment.
Also, you may be required to wear glasses after your surgery. There may be a small change in the prescription following surgery. This is best evaluated 6 weeks after surgery.