Eye-muscle surgery is often performed on children with strabismus and other visual conditions.  Eye-muscle surgery is performed on an outpatient basis at the hospital, most often under general anesthesia.  Before the surgery, we carefully measure the eye's position to determine which muscles to operate on, whether we will operate on one or both eyes, and how much the muscles must be moved to position the eye correctly.  Taking these measurements may require several appointments, and we may need to take additional measurements on the day before surgery.  We are very careful, because the success rate of eye-muscle surgery is not 100 percent, but instead hovers around 60-80 percent.  This means that about seven out of ten patients who undergo eye-muscle surgery attain a good result with only one procedure.  The remaining three patients may, at some point, need additional surgery for good eye position.  The success rate of each surgery is always the same: 60-80 percent.

The Surgical Procedure

Surgery to correct the eye's position is a common procedure.  It does not involve cutting into the eyeball, nor does it require that the eye be "taken out" to reach the muscle.  A small incision into the transparant covering of the eye (the conjunctiva) is made to reach the muscle.  The muscle is then repositioned and reattached with tiny sutures.  The conjunctiva is also closed with tiny sutures, which will dissolve on their own within one to two weeks.  Once the surgery is over, your child may return home after awakening.  Most patients spend several hours in the outpatient surgery area, and then go home in the mid-afternoon if the surgery is performed in the morning. 

After Surgery

After the surgery, the eyes will be quite red in the areas that were operated on, and they may display a jelly-like swelling.  This is normal and will clear over the next few weeks.  Sometimes the redness spreads before clearing; this is normal and no cause for alarm.  Antibiotic eye drops will be prescribed for use after the surgery for five to seven days, according to the doctor's instructions. 

In most cases, no patches or bandages over the eyes are required after surgery.  Glasses, if worn, may still be worn after the surgery.  Please remember to bring the glasses with you for your post-operative visit.  If your child wears an eye patch, we will discuss this with you at the first post-operative visit.

Discomfort following eye-muscle surgery is usually minimal.  Most patients feel as if they have a foreign body in their eye(s), or they experience some discomfort in eye movement for a day or two.  Pain medicine is usually not necessary, but you may use Tylenol as needed.  Some children may experience temporary double vision after the surgery.  This is a normal part of healing, as the brain must "get used" to the new position of the eyes.  The double vision usually disappears within a few days after surgery, but may last longer.

Children should stick to light physical activity for ten days after surgery.  They should refrain from exercising, physical education (P.E.), running, jumping, or heavy lifting during this period.  After ten days, they may swim--preferably with goggles until all redness is gone. 

Follow-Up Schedule

Children who have had eye-muscle surgery should see their Pediatric EyeCare specialist a few days after surgery, on the following week, and then again six weeks after surgery.  The healing process is gradual and lasts about six weeks.

If you suspect that your child may need eye-muscle surgery, please call us for an appointment, or use our online appointment request form.

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