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Strabismus Surgery Questions

When will my child or case be scheduled?
We usually schedule pediatric and adult muscle cases to be the first cases, with start times around 7:30 A.M. on a Wednesday at the Orange City Surgery Center.  The exact time for arrival will be confirmed by a telephone call from both our surgical scheduler and the surgery center staff several days before.

Do we need a medical clearance before surgery?
Since most children are naturally healthy a clearance is not needed. If you are an adult in good health or have a stable medical condition a clearance is not required. If you have an ongoing heart, lung, metabolic, or prior anesthetic risk problem then a clearance form will be sent by our office to your primary care physician or specialist most familiar with your condition for completion.

How do you move the eye muscles?
The “extraocular’ muscles are attached to the outside of the eye. During surgery we never remove the eye from the socket. The muscles are like thick rubber bands, each located a certain distance (4-7 mm) from the limbus, where the clear cornea and the white sclera meet. We gently lift the transparent skin of the eye (conjunctiva) and use small finger like hooks and instruments to locate the muscle. We can shorten or reposition the muscles and attach them back to the eye with absorbable suture.

Is there any pain felt during surgery?
No. The majority of cases are done with the patient being asleep under general anesthesia. Intravenous medications are used to eliminate sensation, provide pain relief, and offer an amnesia effect.

Is there much pain after surgery?
Most patients will have some degree of pain or discomfort during the first 24 hours. A foreign body sensation, burning, and scratchiness are often experienced. Usually, over-the-counter medications like Motrin or Tylenol used every 3-4 hours while awake will provide relief. Short naps and minimal distractions are recommended.

How safe is surgery and anesthesia?
Strabismus surgery is relatively safe. The muscles are located outside the eye and the interior parts are not touched nor disturbed. It is extremely rare to get an infection, much bleeding, or vision loss. The most common problem is redness over the area of the incisions which may last for several weeks. Healing may take up to a month before we know whether further surgery  or use of prisms for double vision is needed. The general anesthesia is constantly being monitored and controlled by certified physicians and nurses. They are available to talk with before surgery if you have any additional questions.

What medications are used after surgery?
Although there are various formulas followed, we recommend for our patients to use a combination of topical antibiotic/steroid drops 3-4 times a day along with a similar form in ointment at night and, as needed, for several weeks. With some children, the ointment is better tolerated several times a day. In cases where the eyelids may get stuck by dry mucous, we instruct patients or parents to use Q-tips, wet with warm water, and gently wipe the lid margins clean.

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