Should I get eye muscle surgery?
April 14, 2011 11:17 AM   Subscribe

I have Strabismus, a misalignment of the eyes which causes double vision. It's a condition I've dealt with my whole life but which had largely only manifested itself during periods of above-average tiredness, fatigue, or intoxication. As I passed through my 20s and now into my mid 30s, the condition has worsened to the point where it affects me every day, and I want to fix it. I'm considering eye muscle surgery, but I'd like to hear some personal accounts as to the effectiveness of this treatment. Positive or negative experiences are welcome, as well as non-surgical treatment ideas.
posted by srkit to Health & Fitness (13 answers total) 4 users marked this as a favorite
I've had two eye muscle surgeries for strabismus, one when I was a year, and one when I was 13 years old. The latter was done by Graham Quinn at CHOP.

The surgery itself is a pain in the you know what. As a teenager, I was glad to have my parents to take care of me, because it was a good month before I was seeing well enough to go out without sunglasses on my own. The first few days, where I couldn't open my eyes at all, were terrible.

That all being said, I'm THRILLED with how it's changed my vision. My eyes don't turn, no double vision, etc. I just had a check up last week, 17 years after the surgery (don't know how I got so old), and everything still looks great.
posted by roomthreeseventeen at 11:23 AM on April 14, 2011

I had the surgery for strabismus as a little kid, maybe 7 or 8 years old. I remember I wore an eye patch for a little while. Don't remember much else about it.
I went from "needs glasses" to "effectively perfect vision for the rest of my life so far", just like that. And I have been staring at computer screens almost constantly for the last 15+ years :)

My son is 2 years old now, and hasn't shown any signs of it. But if he did, I would most probably get him the surgery.
posted by jozxyqk at 11:34 AM on April 14, 2011

I've always associated strabismus with crossed eyes, but your description of your condition prompted me to look up the definition. When I was in my 20s I mentioned some strange visual problems I'd been having - like double vision when I was very tired - to my ophthalmologist (I already wore glasses for nearsightedness), he did a variety of tests and informed me that my eyes were out of alignment and that I also had a muscle problem. He never used the word "strabismus" in conversation, but it sounds like that's what I've got. He added prisms to my eyeglass prescription. He told me that maybe "some day" I might want to consider surgery if it got to the point where prisms in the lenses no longer corrected the problem. That was almost 30 years ago and even though over the years my prism prescription has gotten progressively a wee bit thicker, my glasses still keep my vision in alignment. Only if I get tired to the point that I'm starting to nod off do my eyes start "wandering" and giving me double/triple/quadruple vision, even with my glasses on.
posted by Oriole Adams at 11:39 AM on April 14, 2011

I suggest you visit and post your question there.
posted by eas98 at 11:46 AM on April 14, 2011 [1 favorite]

We have a pediatric opthalmologist that does several of these a week, usually on children less than 10 years of age, and she usually gets excellent results. The most common problem by far is that the correction is too much/not enough and she has to revise the surgery; this sometimes becomes necessary as the patient grows. Even this is very uncommon, though. The surgery itself is pretty straightforward and well tolerated; the patients go home that day unless they have other issues that make it better to admit them One thing that is noteworthy about strabismus surgery is that it does have a higher incidence of postoperative nausea and vomiting than most operations and it will take a little while for your eyes to get used to their new alignment; if you decide to get the surgery your surgeon can discuss how these may or may not apply to you in more detail.
posted by TedW at 11:54 AM on April 14, 2011

My little guy had strabismus and amblyopia, and had surgery when he was about 3. He's 6 now, and still wearing glasses, so it's probably a little premature for a verdict. But he's much better, and his surgeon is optimistic.
posted by troywestfield at 12:27 PM on April 14, 2011

I first started developing this in my early teens and left it untreated until I was 28. Before that, I just struggled through as it got worse and worse. Driving was incredibly tiring (and in retrospect, probably dangerous), and it also made me very socially anxious. I avoided eye contact whenever I was too tired to pull my eyes together. I can't even begin to tell you how much of a difference it made in my life to be able to 'see straight' after the procedure; brain plasticity is a wonderful thing, as my vision is now fused 99% of the time and I very seldom get double vision, I experience much fewer headaches, etc.

I was evaluated several times before finally going through with the surgery. Prisms and exercises were deemed unlikely to help. My evaluations were typically through pediatric ophthalmologists since this often arises in and is treated in children, although the doctor I ended up going with when I finally did it was a general oculoplastic surgeon. My deviation in both eyes was quite severe (over 75 degrees) and as such two procedures were necessary. I had both the inner and outer muscles resected, and the procedures were seven months apart. After the first procedure, I could pull my eyes together much more easily, but they still wandered a fair bit; after the second, they were just about perfect. Vision improvement was immediate--no adjustment period. It was like I had new eyes.

The recovery was fairly quick, with dissolving sutures... in both cases I was back to work in a few days. Antibiotic drops that gradually decreased in frequency (4x/day, 3x/day, 2x/day, 1x/day) over a 20-day period were the only treatment. Pain was not too bad, even immediately post-op. OTC painkillers were enough. Honestly, the worst part was aesthetic: your eyes are a bit bloody for a while and it takes some time (a few weeks) to clear up, so it's visually striking, but it goes away.

If you have any further questions about the procedure or the experience, just shoot me a memail. On the off chance that you're in the vicinity of Columbus, Ohio, my procedure was performed by Dr. Steven Katz at the Ohio State University hospital, and he did an outstanding job. Not super chatty, but he told me everything I needed to know and really cared about the quality of his work.
posted by Kosh at 1:26 PM on April 14, 2011 [3 favorites]

I have strabismus and had two surgeries when I was young (one when I was three, and one when I was five). The first surgery greatly improved my eyes (cosmetically at least) and the second made them a little worse. However, my eyes look a lot better than they did in early pictures and I can drive, etc without a problem.

I don't remember much about the recovery times from the surgeries, but it was a little scary to not be able to open my eyes for a while.
posted by DeucesHigh at 3:06 PM on April 14, 2011

When I was 3, I had surgery for being cross-eyed which apparently overcorrected, then surgery twice for strabismus at about ages 8 and 12. The second one remained effective for about ten years, at which point the strabismus returned - although I don't know if to the same degree. After the last surgery, I acquired the ability to look out of either or both of my eyes at once at will. In the last few years, the eye that I am not looking out of tends to wander if I'm focusing on a nearby object, although I can easily control it consciously.

Interestingly, I do perceive 3D, but I get it much more from 3d movies and the 3DS than from real life.

Oh, and the months leading up to the later two were constant terror for little old me. Ugh.
posted by Earl the Polliwog at 5:52 PM on April 14, 2011

After years of successfully coping and compensating for strabismus, my eyes went nuts a couple of years ago in the wake of a new contact prescription. Result: surgery on both eyes, followed by Lasik. It is by far the best health decision I ever made, and I wish I'd done it years earlier. Although it did not correct the problem 100%, it was not worth having a second procedure for the final 5-10%. I don't get much out of 3D movies, but I can look at you from both directions, which rocks.

The procedure itself was not fun: it's done under general anesthesia, and you're going to be laid up for at least a few days with your eyes closed and some painkillers (when you open your eyes they automatically try to focus! and focusing chopped and stitched muscles hurts!). Nevertheless, it's been so worthwhile. If you're in the DC metro area, memail me for a surgeon rec.
posted by amber_dale at 5:55 PM on April 14, 2011

I had double exotropia, which is to say that both of my eyes turned outwards (the opposite of being cross-eyed). My doctor tried to correct it first with an eye patch, hoping my eyes would strengthen enough that surgery wouldn't be necessary. Alas, I did end up needing surgery, when I was 5. This was before the surgery was very common, but I lucked out with an excellent surgeon. He thought I might need follow-up surgery the next year because of a slight overcorrection, but decided the patch i was wearing was doing what it was supposed to.

As to recovery, I remember it being very easy. In fact, I was watching TV the evening of my surgery (though Bewitched was interesting to watch with two Elizabeth Montgomeries).

Now, 28 years later, I notice that when I'm exceptionally tired, my eyes do cross a bit (due to that slight overcorrection), but otherwise the surgery was a total success. Given that my aunt is functionally blind in one eye because of an uncorrected lazy eye, I know it could have been much worse.
posted by devinemissk at 7:07 PM on April 14, 2011

No idea if this is relevant:
posted by sully75 at 1:46 AM on April 15, 2011

Get your blood tested - I went to the doctor with similar symptoms and was told that low iron can cause it - it may worsen it too.

I had my eyes checked out at the hospital, so I don't have strabisimus, but someone who does and also has a low iron count may find it worsens.
posted by mippy at 4:04 AM on April 15, 2011

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