In the case of a misalignment of the eyes, such as strabismus, often only eye muscle surgery can help the affected person. During eye muscle surgery, doctors correct the misalignment of the eyes so that both eyes can focus on the same target.
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Eye muscle surgery - Further information
When can eye muscle surgery help?
Surgery can help if the eyes are misaligned. This misalignment can usually be recognized by the fact that the affected person squints (strabismus). For this reason, eye muscle surgery is sometimes referred to as strabismus surgery.
The strabismus caused by the misalignment of the eyes is not just a visual obstacle. It can also lead to severe visual impairment. Surgery is therefore often necessary in childhood in order to avoid consequential damage caused by the misalignment.
Eye muscle surgery is not only an option for strabismus, but also for eye tremors (nystagmus) or ocular-related forced postures of the head.
Whenever the mechanics, mobility or position of the eyes are affected, surgery can help. Doctors only perform eye muscle surgery if other options are not possible to restore symptom-free vision.
Surgery is often performed on children because of the possible developmental consequences. Adults usually have it performed for cosmetic reasons.
Illustration of the eye muscles of the left eye
Need for eye muscle surgery
Surgery isnot necessary for every misalignment of the eyes. Minor misalignments in particular usually have no effect on vision. The brain compensates for this minimal disorder without any problems.
In adults, eye muscle surgery is possible at any time. In children, however, doctors wait with the operation until the child can see equally well in both eyes. Vision is fully developed from around the age of 6.
Eye muscle surgery therefore makes sense at preschool age at the earliest. Before that, other methods are used to get the affected eye to see properly. If this is not successful, you should consider surgery.
Untreated misalignments from childhood usually stabilize with age, so there is no further deterioration in vision. Surgery is not necessary.
It is rare for the misalignment to develop as a result of paralysis of the eye muscle in adulthood. In this case, eye muscle surgery may be useful to restore vision.
Before eye muscle surgery
If eye muscle surgery is performed under general anesthesia, you must not eat anything for around six hours before the operation. This also includes cloudy liquids. You should therefore only drink water.
You should also stop drinking watertwo hours before the eye muscle operation. You should refrain from smoking on this day.
If you are taking medication, please inform the doctor. He must adjust the anesthesia accordingly.
The type of anesthesia used usually depends on the age of the person concerned. Doctors generally use general anesthesia for children to avoid unexpected reactions during the operation. The same applies to particularly anxious or sensitive people.
Local anesthesia is usually sufficient for eye muscle surgery. The anaesthetic ensures that reflexes are suppressed. Movement is not possible and the patient feels nothing.
Procedure for eye muscle surgery
Depending on the condition, eye muscle surgery can be performed in different ways:
- In the case of strabismus, doctors surgically correct the strabismus angle of the eye. This involves aligning the eye axis of the deviated eye parallel to the healthy eye.
- If strongly pulling eye muscles cause the misalignment, doctors retract the muscles on the eyeball. If the muscles are too weak, they tighten them to compensate for the misalignment of the eyes. It is not necessary to open the eye. Only the conjunctiva is incised during eye muscle surgery. However, the incision usually heals very quickly.
- Doctors can also treat paralyzed muscles during surgery. They weaken the counterpart of the paralyzed muscle and remove it.
- Sometimes only a fold is made during the operation to correct double vision.
- If the deformity is severe, several operations are necessary to achieve an optimal result for the affected person.
Disinsertion of the tendon of the left rectus medialis muscle
During the procedure, doctors open the conjunctiva and then suture it back together. This causes swelling in the eye. Doctors use a special thread to suture the conjunctiva. This thread dissolves on its own after about a week.
However, the dissolving of the suture can cause an unpleasant feeling in the eye within the first few days after the procedure. The eye perceives the remains of the suture as a foreign body and produces a large amount of tear fluid.
The duration of eye muscle surgery depends on the severity of the procedure. The more muscles are affected, the longer the operation will take.
Follow-up treatment after eye muscle surgery
In principle, all patients can return home in the evening if they feel well after the operation. Only rarely do patients have to stay in hospital for monitoring after the operation. Here too, however, patients can expect to be discharged within a few days.
After eye muscle surgery, patients usually suffer from a slightly swollen and reddened conjunctiva. The swelling continues to increase for the first four days, but then slowly decreases and heals.
Thorough follow-up treatment is essential after eye muscle surgery. This is the only way to ensure that the healing process runs smoothly and reduces consequential damage.
To this end, the person affected must apply special drops to the operated eye at least three times a day. In some cases, the attending physician will also prescribe ointments after eye muscle surgery .
To apply the drops well into the affected eye, you must carefully pull the lower eyelid downwards. It is also advisable to look upwards. It is best to carry out the procedure in front of a mirror.
Many people find it helpful if another person is present when the eye drops are administered. Children in particular should only apply eye drops under the guidance and assistance of an adult.
This allows the drops or strips of ointment to reach the lower conjunctival sac directly. You should be careful not to touch the eyeball with the bottle during this follow-up treatment. This could cause injury to the freshly operated eye.
Special considerations for children
Children often do not open the affected eye after eye muscle surgery as the new situation is unfamiliar to them. This is not a bad thing and is completely normal.
So do not insist that the child opens the eye. Instead, give your child enough time to adjust to the situation. As long as the child does not open the eye, you can do without treatment with drops and ointments.
After a while, the child will try to open the eye on its own. From this point onwards, you should carry out follow-up treatment with medication on the eye.
Behavior after eye muscle surgery
After eye muscle surgery, those affected do not have to observe any special behavioral rules. The only exception is visiting public swimming pools. You should avoid these until around three weeks after the operation. The chlorine contained in the water can damage the freshly operated eye and impair the healing process.
Reading, flying by plane or physical exertion are permitted, but you should attend regular check-ups with your ophthalmologist.
Follow-up examinations
Before you are discharged from hospital, your doctor will give you your next check-up appointment. You should keep this appointment as a matter of urgency.
Generally, the first check-up takes place a few days after the eye muscle surgery. However, if you experience any symptoms before then, you must go to the nearest doctor or hospital immediately. This is particularly the case if you have a high temperature or severe pain.
Risks of eye muscle surgery
The risks of eye muscle surgery are very low compared to other operations . Complications only occur very rarely during the procedure.
In rare cases, post-operative bleeding or infection may occur after the operation. In addition, there may be pain when moving the eyes in the two days following eye muscle surgery.
However, this is harmless and no cause for concern. After a few days, there will be a clear improvement. If the pain is unbearable, you can treat it with special painkillers. All you need to do is consult your doctor after the operation.
If the result is not as desired, you may have to have the eye muscle operated on again. In the case of difficult clinical pictures, the therapy generally requires several surgical steps.