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Eye muscle repair is a surgical procedure that corrects a muscle imbalance in the eyes. The muscle imbalance causes the eyes to cross inward or outward. This is a condition called strabismus. People with strabismus have eyes that do not work together. As a result, the eyes point in different directions.
Eye muscle repair surgery helps realign the eyes so that both point in the same direction. This treatment is most often performed on children but is also used to help adults with eye muscle problems.
Some people successfully overcome strabismus by doing eye exercises or by wearing eyeglasses. Eye muscle repair surgery is a solution for those who do not show improvement through nonsurgical means.
You will undergo a complete physical and eye examination before eye muscle repair surgery. The doctor will note any prior treatments you have tried to fix your eye muscle problems. He or she will also take eye measurements and determine which muscles are weaker or stronger than they should be.
Seven to 10 days before your surgery, you will need to stop taking medications that can increase your risk of bleeding. Medicines in this category include:
Fasting before the surgery is required to avoid adverse reactions to anesthesia, such as nausea and vomiting. Your doctor will let you know when to have your last meal, based on the time of your surgery.
Children usually undergo eye muscle repair with a general anesthetic, meaning they are asleep and feel no pain. Adults who need eye muscle repair are generally treated with a local anesthetic that numbs the eye.
The surgeon will make a small incision in the clear membrane that covers the white of your eye. Once the surgeon has access to the muscles, he or she will either shorten or stretch them as needed to properly realign your eye. The entire procedure takes about 90 minutes.
Shortening the eye muscles is called a resection, and this strengthens the muscles. The surgeon removes part of the muscle or a neighboring tendon to resection the muscle. Weakening the muscles is called a recession. The muscle is stretched and reattached to a point farther back in your eye.
Some people with strabismus require surgery in only one eye, while others may need to repair both eyes. One or more muscles in the eyes can be repaired during the same surgical procedure.
Risks of eye muscle repair include double vision, eye damage, bleeding, and infection. Double vision and damage to the eye structures are rare side effects of the surgery.
Bleeding and infection are possible risks with any type of surgery. Reduce your risk by keeping your incisions dry and clean, and following your doctor’s instructions regarding blood-thinning medications.
If you wait too long to treat eye muscle problems, vision loss could become a permanent disability. According to the Mayo Clinic, you should treat strabismus as early as possible to avoid lifelong vision problems. Young children experience a better outcome than older kids or adults.
The results of eye muscle repair surgery are often immediate.
In some cases, even if your eyes are no longer crossed, follow-up treatment may still be required for vision problems, because strabismus can lead to reduced vision in some people. Even though the eye muscles are corrected surgically, vision loss can remain. Eyeglasses and contacts, for instance, treat a variety of vision problems that may remain, including nearsightedness, farsightedness, or astigmatism.
Children who have lost vision or suffer from poor vision associated with strabismus may need to continue wearing an eye patch following the surgery. The length of time it must be worn depends on the severity of the condition. Eye patches are used when one weak eye leads to crossing. Patching the strong eye, even after surgery, helps stimulate the weaker eye. The patch also helps a child’s brain develop more fully in the area that manages vision. Your child may wear an eye patch for at least two hours daily to strengthen a weak eye.
Eye muscle repair surgery is usually an outpatient procedure, meaning that you can go home the same day. Keeping the eyes free of dirt and infection is of utmost importance. You may be prescribed an antibiotic eye drop or ointment as a precautionary measure. Try not to touch or rub your eyes for several days after your surgery, even though your eyes will feel scratchy and painful. Redness and watering of the eyes are common aftereffects of the surgery.
Schedule a follow-up appointment with your eye surgeon for one to two weeks after your eye muscle repair surgery. By this point, you should feel more comfortable, and your eyes should look normal.