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Overview

 

Eye Muscle Surgery Is Performed To Weaken, Strengthen, Or Reposition Any Of The Extraocular Muscles (Small Muscles) Located On The Surface Of The Eye That Move The Eyeball In All Directions.

The Extraocular Muscles Attach Via Tendons To The Sclera (The White, Opaque, Outer Protective Covering Of The Eyeball) At Different Places Just Behind An Imaginary Equator Circling The Top, Bottom, Left, And Right Of The Eye. The Other End Of Each Of These Muscles Attaches To A Part Of The Orbit (The Eye Socket In The Skull). These Muscles Enable The Eyes To Move Up, Down, To One Side Or The Other, Or Any Angle In Between.

Normally, Both Eyes Move Together, Receiving The Same Image On Corresponding Locations On Both Retinas. The Brain Fuses These Matching Images Into One Three-Dimensional Image. The Exception Is In Strabismus, Which Is A Disorder Where One Or Both Eyes Deviate Out Of Alignment, Most Often Outwardly (Exotropia) Or Toward The Nose (Esotropia). In This Case, The Brain Receives Two Different Images, And Either Suppresses One Or Allows The Person To See Double (Diplopia). By Weakening Or Strengthening The Appropriate Muscles To Center The Eyes, A Person Can Correct This Deviation. For Example, If An Eye Turns Upward, The Muscle At The Bottom Of The Eye Could Be Strengthened.


Diagnosis/Preparation

Depth Perception (Stereopsis) In Humans Develops Around The Age Of Three Months. For Successful Development Of Binocular Vision And The Ability To Perceive Three-Dimensionally, Eye Muscle Surgery Should Not Be Postponed Past The Age Of Four Years. The Earlier The Surgery, The Better The Outcome, So An Early Diagnosis Is Important. Surgery May Even Be Performed Before The Child Is Two Years Old.

Patients (Or Their Caregivers) Should Make Sure Their Doctors Are Aware Of Any Medications That They Are Taking, Even Over-The-Counter Medications. Patients Should Not Take Aspirin, Or Any Other Blood-Thinning Medications For 10 Days Prior To Surgery, And Should Not Eat Or Drink After Midnight The Night Before.


Risks

Risks For Any Anesthesia Are:
  • Reactions To Anesthesia Medicines
  • Breathing Problems


Risks For Any Surgery Are:
  • Bleeding
  • Infection


Some Other Possible Complications Are:
  • Wound Infections.
  • Damage To The Eye. This Is Rare.
  • The Surgery Does Not Correct The Problem And The Eye Is Still Out Of Place.
  • Permanent Double Vision. This Is Rare.


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Before The Procedure

Your Child’s Eye Surgeon May Ask For:
  • A Complete Medical History And Physical Exam Of Your Child Before The Procedure
  • Orthoptic Measurements (Eye Movement Measurements)


Always Tell Your Child’s Doctor Or Nurse:
  • What Drugs Your Child Is Taking.
  • Include Any Drugs, Herbs, Or Vitamins You Bought Without A Prescription.
  • Tell Them About Any Allergies Your Child May Have To Any Medicines, Latex, Tape, Or Soaps Or Skin Cleaners.


During The Days Before The Surgery:
  • About 10 Days Before The Surgery, You May Be Asked To Stop Giving Your Child Aspirin, Ibuprofen (Advil, Motrin), Warfarin (Coumadin), And Any Other Drugs That Make It Hard For Blood To Clot.
  • Ask Your Child’s Doctor Which Drugs Your Child Should Still Take On The Day Of The Surgery.


On The Day Of The Surgery:
  • Your Child Will Usually Be Asked Not To Drink Or Eat Anything For Several Hours Before The Surgery.
  • Give Your Child Any Drugs Your Doctor Told You To Give Your Child With A Small Sip Of Water.
  • Your Child’s Doctor Or Nurse Will Tell You When To Arrive For The Surgery.
  • The Doctor Will Make Sure Your Child Is Healthy Enough For Surgery And Does Not Have Any Signs Of Illness. If They Are Ill, The Surgery May Be Delayed.


After The Procedure

This Surgery Is Usually Done On An Outpatient Basis. The Corrected Eye Is Usually Straight Right After Surgery.

Your Child Will Be Kept From Rubbing Their Eye Until They Have Recovered From Anesthesia. Eye Rubbing Later On Is Not A Problem, Since Children Close Their Eyes When They Rub Them.

After A Few Hours Of Recovery, The Child May Go Home. You Should Have A Follow-Up Appointment With The Eye Surgeon 1 To 2 Weeks After The Surgery.


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