What is strabismus?

Strabismus (or 'squint') is where one of your eyes points in towards your nose (convergent) or out towards your ear (divergent). Sometimes one eye may point up or down. Strabismus may be present all the time or only sometimes.

How does strabismus happen?

Strabismus in adults can happen because of disease that affects your eye muscles (such as thyroid eye disease and myasthenia), disease that affects the nerves to your eye muscles (such as high blood pressure and diabetes) or trauma (where a physical force is applied directly to your eye).

Strabismus can also be caused by trying to correct short- or long-sightedness, or by poor vision in one eye as a result of amblyopia (or 'lazy eye').

Strabismus may not cause any symptoms. For some people it can be serious.

What are the benefits of surgery?

The aim of surgery is to improve the alignment of your eyes and reduce or stop any double vision.

Are there any alternatives to surgery?

Glasses or contact lenses can sometimes be used to control strabismus by helping your eyes to focus.

Double vision can often be controlled by wearing glasses with special prism lenses.

Botox injections into an eye muscle can temporarily help to straighten an affected eye.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible. The operation usually takes about 1 to 2 hours.

Your surgeon will make a small cut on the surface membrane of your eye (conjunctiva). They will separate one or more eye muscles from the surface of your eyeball.

Usually using small dissolvable stitches, your surgeon will reattach the muscles, making them tighter or looser than they were before. This will depend on the correction that needs to be made.

How can I prepare myself for the operation?

Helping your surgeon

If you have adjustable stitches, you can help your surgeon by relaxing, listening carefully and following the instructions they give you.

Lifestyle changes

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

General complications of any operation

• bleeding
• infection
• allergic reaction to the equipment, materials or medication
• chest infection

Specific complications of this operation

• continued strabismus
• worse strabismus
• double vision
• a slipped or lost eye muscle, muscle scarring or making a hole in the eye with a needle
• reduced blood supply to the front of the eye

Consequences of this procedure

• scarring of the conjunctiva
• pain

How soon will I recover?

You should be able to go home after a few hours.

Do not swim or lift anything heavy until you have checked with your surgeon. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery.

Summary

Strabismus surgery should make your eyes point in the same direction and improve any double vision.

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