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Surgery for strabismus

 

What is strabismus?

Strabismus (stru-BIS-muss) is an eye condition where both eyes do not look in the same direction. Common names are “crossed eyes” and “wall eye.” Your child’s health care team might say the eyes are “out of alignment.” Both eyes do not point the same way at the same time.

Why does my child need surgery for strabismus?

Strabismus treatments include glasses, prisms, eye patches, and drops that make the vision blurry in one (1) eye. They also include shots to help relax the eye muscles. Your child might have a combination of these treatments. If these treatments do not work, your child might need surgery on their eye muscles. They might need it on both eyes, even if only one (1) eye looks in the “wrong” direction.

What happens during strabismus surgery?

Strabismus surgery takes one (1) to 2 hours or less. Your child has general anesthesia, so they are asleep during surgery and do not feel anything. They do not usually need to stay in the hospital overnight.

During surgery, your child’s doctor uses a small device to hold the eyelids open gently. Then, they make a small opening through the eye’s surface. They adjust one (1) or more of the eye muscles, using stitches that dissolve. There is no need to take the stitches out later, because they melt away on their own.  The eye is never removed to do the surgery.

What to expect after surgery

The main thing you will notice is that your child’s eye looks bright red. This happens because the front of your eye is clear. After surgery, you can see any blood that is present. The redness might last a week before it starts to change. It can take a month or two before the eye looks completely white again.

You might also notice that your child’s tears are slightly red from blood. This does not mean your child is hurt. It happens because the eye has many blood vessels. This redness in the tears usually goes away in a few hours.

Your child’s eyes will also be sticky with mucus for a few days. The eyelids might stick together at times. You may wipe it away gently with a clean, damp washcloth, but do not rub the eye or get water in it.

Treating pain after surgery

Tylenol® or Motrin® are usually enough to relieve pain after strabismus surgery. You can also put a cool washcloth or cold pack on your child’s eye after surgery. This can be an ice pack, a clean washcloth soaked in ice water and wrung out well, or a bag of frozen peas. Wrap the ice pack or bag of frozen peas in a clean washcloth before putting it on your child’s eye.

Activities after surgery

 Your child will probably get back to normal activity in one (1) to 5 days. They should avoid the following things for 2 weeks after surgery.

  • Getting water, soap, or shampoo in their eyes.
  • Rubbing their eyes.
  • Rough play – Such as running full speed, wrestling, playing tag, or other active games.
  • Swimming.

Will my child’s eyes look in the same direction after surgery?

Your child’s eyes might look in the same direction, or be “aligned,” immediately after surgery. Or they might not. The eyes will look red and a bit swollen. They might become straighter within 1 or 2 days after surgery, but you might not be able to see it yet. This is because of bruising and swelling. Your child’s eyes might look straighter as they heal. It takes 4 to 6 weeks to know if the surgery was effective.

Your child might “see double” after surgery. This can take a few days to weeks to go away.

I’m concerned. Should I call the eye clinic?

Yes. If you are concerned at all after strabismus surgery, call the clinic as soon as possible. Call the Medicine Room if the clinic is closed.

Infection after strabismus surgery is uncommon. Also, your child’s doctor will give you antibiotic drops to help prevent infections after surgery. But is always possible when there is an opening in the body. Your child might have an infection if the swelling gets worse, the eye or eyelid becomes red, or you see pus coming from their eye. Other signs of infection are a fever and pain that gets worse.

When can my child go back to school?

This is different for every child. Most children can go back to school in 2 or 3 days as long as they are recovering well and do not have double vision. However, they should not go to recess or gym or PE class for 2 weeks after surgery. Your child’s doctor might also ask your child to skip school or other activities so they can heal.

Questions?

If you have questions about your child’s strabismus surgery, talk to the eye doctor or nurse. You can call the Eye clinic at 901-595-3255 or call your child’s primary clinic. You may also call the Medicine Room at 901-595-2441.


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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