Strabismus Surgery in Canberra
Strabismus surgery (eye muscle surgery) is a procedure
for the treatment of eye misalignment.
What is Strabismus Surgery?
Strabismus surgery (eye muscle surgery) is a procedure for the treatment of eye misalignment.
Strabismus is the condition where the two eyes are not aligned with each other. This means that when one eye is looking straight ahead, the other is in a different direction.
What eye issues can Strabismus Surgery treat?
Strabismus surgery is to correct eye misalignment, including horizontal, vertical or complex misalignments.
People with strabismus have difficulty controlling their gaze. One eye may be looking at something directly, while the other eye is looking off somewhere else.
Strabismus surgery is performed for several types of eye misalignment, including:
Estropia: Convergent misalignment, i.e. when the eye turns inwards, towards the nose.
Exotropia: Divergent misalignment, i.e. when the eye turns outwards, away from the nose.
Hypertropia: When one eye is higher than the other
Hypotropia: When one eye is lower than the other
Cyclotropia: Most commonly, it is due to one eye rotating outwards or inwards around its visual axis.
Why is Strabismus Surgery needed?
Here are some reasons why people need to undergo strabismus surgery:
» To align the eyes to regain three-dimensional vision and depth perception.
» To improve clarity of vision and eliminating double vision.
» To prevent or treat “lazy eye”.
» To improve appearance and alignment.
» To prevent long-term visual and developmental issues in paediatric patients.
» To improve quality of life and overall well-being.
Strabismus Surgery Techniques
Strabismus surgery can be undertaken in several different methods, depending on the exact nature of the misalignment that is being addressed. There are six extraocular muscles (eye muscles) for each eye, and these move the eye in different directions.
The eye muscle is detached and reattached further back in the eye. The result will be weakening of that muscle’s function.
The procedure for strengthening eye muscles requires shortening of the muscle. This can be done via plication surgery, which is safer and reversible in comparison to “resection”.
It may be possible to adjust the muscle position in the first few days after surgery. This is a particularly useful technique when the outcome of surgery might not be predictable, such as repeat surgery or in conditions such as thyroid related strabismus.
Who needs Strabismus surgery?
Strabismus surgery is possible for patients of all ages. Strabismus surgery may be performed for functional or reconstructive purposes. Eye muscle surgery is typically performed on children even as young as 9-12 months old, with the goal of restoring binocular function (both eyes working together). In children, strabismus left untreated can lead to one eye with reduced vision (amblyopia or lazy eye). It may also lead to low self-esteem and bullying related to abnormal appearance. In adults, eye muscle surgery can help treat symptoms of double vision.
In both older children and adults, strabismus surgery may be performed to restore normal appearance.
You may benefit from strabismus surgery if you:
» Have an eye misalignment causing problems with vision or abnormal appearance
» Experience double vision with both eyes open
» Tilt or turn your head to avoid double vision
How to prepare for strabismus surgery
Here are some of the most commonly asked questions about strabismus surgery:
Your ophthalmologist will examine your eye alignment and eye movements in detail, to diagnose the exact nature and size of misalignment. This is used to plan a surgical approach for the eye muscle surgery. A repeat assessment and measurements are usually taken.
Before surgery, it is important to organise a friend or family member to drive you to and from the hospital.
Eye muscle surgery is typically performed under general anaesthesia in a hospital setting.
The muscles to be operated on are accessed under the conjunctiva, and then recessed or plicated. Muscles can also be moved (transposed) around the eye.
When the surgeon reattaches the muscle to the eye wall (sclera), they may either use a permanent knot, or an adjustable suture technique for some adult patients.
After strabismus surgery, your eye may be red for up to 6-8 weeks. You can expect some mild discomfort and irritation during the recovery process. This should settle down in the first few days as your eyes heal and the surfaces stitches dissolve.
Eye drops may be prescribed to reduce inflammation and the risk of eye infection.
Your ophthalmologist will organise follow-up visits to evaluate the healing process and eye alignment.
Most patients resume normal activities about 2 – 3 days after eye muscle surgery. However, strenuous activities including contact sport, and swimming, is not recommended for 4 weeks after strabismus surgery.
What to expect from strabismus surgery
The benefits of surgery vary depending on the goal of the surgery and the condition being treated. Surgery can be a good option to treat double vision. It may also restore normal appearance.
The advantages and risks of strabismus surgery will be different for each patient.
Strabismus (eye muscle) surgery is not a cure-all; it only fixes the parts of your problem that surgically correctable.
Some forms of strabismus respond better to surgery than others, and not all strabismus is amenable to surgery.
Your eye surgeon (ophthalmologist) will be able to tell you how these generalities apply more specifically to your condition.
Alternatives of Strabismus (Eye Muscle) Surgery
There are several non-surgical treatments that can be used to treat strabismus.
Patching the affected eye, injection with botulinum toxin, monocular occlusion, and eye exercises are some of the options available.
Occlusion of one eye (or patching) may be used in some circumstances. It is mainly used to cure amblyopia, or decreased vision associated with strabismus. It can be somewhat helpful in children younger with intermittent outward deviation of the eyes in infancy, called intermittent exotropia.
Here are some common experiences in the days following eye muscle surgery for strabismus:
» Sore, gritty, or red eyes
» Transient double vision
» Eyestrain
» Headache
» Blurred vision
Possible complications of strabismus eye muscle surgery include:
» Residual eye misalignment (usually of smaller angle)
» Over-correction of misalignment
» Change to visual acuity or glasses prescription
» Loss of vision
» New or residual double vision
» Retinal tear or detachment
» Scarring
» Post-operative infections
» Persistent redness
» Droopy eyelid
» Allergic reaction
» Lost or detached eye muscle
Before your surgery, it is important to remember that your surgeon needs to examine you thoroughly and also take into account any existing complications. The post-operative care practices you plan should be followed to minimise additional risks as much as possible.
Call your eye surgeon if you notice any of the following after surgery:
» Increasing redness
» Loss of vision
» Intense eye pain
» Unbearable light sensitivity
» Signs of infection, such as discharge
Expertise of Clarity Eye Surgeons in Strabismus Eye Muscle Surgery
Dr Parth Shah, the principal ophthalmologist at Clarity Eye Surgeons, has many years of experience in performing strabismus (eye muscle) surgery in both children and adults. Dr Shah developed advanced skills in eye muscle surgery through international subspecialty fellowships in the UK and the USA.
He has performed hundreds of procedures, and teaches eye muscle surgery to trainee ophthalmology registrars. He also lectures on eye muscle surgery and has published scientific papers on novel and less invasive eye muscle surgical techniques.
To learn more about Dr Shah’s training and experience, visit his website www.drparthshah.com.au
To make an appointment for a consultation with Dr Shah, contact Clarity Eye Surgeons.
Meet the Best Strabismus Specialist in Canberra
Dr Parth Shah is a highly skilled ophthalmologist based in Canberra. He is the director and principal ophthalmologist at Clarity Eye Surgeons.
Having grown up and trained in Sydney, Parth undertook multiple international surgical fellowships at world renowned institutions in the UK and the USA to develop advanced skills in strabismus surgery.
Parth relocated to Canberra in July 2022 in order to address a need for specialised ophthalmology expertise in the ACT, and take the opportunity to build on the highly successful and busy practice developed by Dr David Dickson for over 25 years.
Parth consults at Clarity Eye Surgeons, and operates at Calvary Hospitals in Bruce, offering both public and private surgery. He also supervises registrars and attends to eye emergencies at Canberra Hospital.
Author Bio
Dr Parth Shah is a director and principal ophthalmologist at Clarity Eye Surgeons in Canberra, specialising in strabismus surgery. With extensive training and experience, he is renowned for his expertise in the field. Dr Shah is dedicated not only to performing successful surgeries but also to patient education. His compassionate approach, combined with technical proficiency, has earned him the trust and gratitude of countless patients. He is a true advocate for eye health and a trusted name in the Canberra ophthalmology community.
FAQs
Strabismus surgery typically takes about 45 minutes to an hour, depending on the complexity of the case and the number of muscles being adjusted. The procedure is usually done as a day procedure, meaning patients go home the same day.
In some cases, one surgery is sufficient to correct the eye alignment. However, about 20-30% of patients may require additional surgeries if the misalignment persists or recurs. Your ophthalmologist will monitor your progress and determine if further treatment is necessary.
Non-surgical treatments include eye patches, corrective glasses, and prism lenses, especially for mild misalignments or when surgery is not an option. Eye exercises may help in certain cases, particularly in children. However, severe strabismus usually requires surgery for optimal correction.
The initial recovery from strabismus surgery takes about 1 to 2 weeks, but complete healing, including full stabilisation of eye alignment, can take up to 2-3 months. Regular follow-up appointments are important during this period to monitor progress.
Strabismus surgery primarily corrects eye alignment and is not aimed at improving visual acuity (clarity of vision). However, in some cases, aligning the eyes properly can enhance depth perception and reduce double vision, indirectly improving overall vision quality.
Most patients experience mild discomfort and irritation following surgery, but it is not typically described as painful. Eye drops and medications are prescribed to manage any post-surgical discomfort, and the redness usually subsides within a few weeks.
Yes, in some cases, strabismus can recur after surgery. This is why ongoing monitoring is crucial. If strabismus does return, additional treatments or surgeries may be necessary to maintain proper alignment.
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