Children’s squint (strabismus) surgery
A squint or strabismus is a condition where the eyes are misaligned or crossed. One eye can turn in (convergent), out (divergent), up, or down. Squints can occur in approximately three out of 100 (3%) of children. Surgery may be recommended if there is a chance of restoring your child’s ability to use their eyes together or improving the appearance of the two eyes. Surgery can be carried out at any age.
Description of treatment
The surgeon will open the eyelids while your child is asleep under general anaesthetic. The surgeon will not cut around the eye so there are no scars on the eyelids. On the white part of the eye (sclera) there is a layer like cling-film called the conjunctiva. When this is cut the surgeon can see the eye muscles. These muscles control the position and movement of the eyes. The surgeon will move these muscles to make them stronger or weaker.
How does it work?
By moving the position of the eye muscles, the position of the eyes changes to appear straighter and in some cases restore normal movement of the eyes.
What can the patient expect?
Squint surgery is usually carried out under a general anaesthetic, which means your child is asleep for the surgery. Your child will usually wake up with one eye pad on, which is then taken off almost immediately.
Most squint surgery is done as a day case operation, and usually takes about an hour. When your child is awake and has eaten and drunk and been to the toilet you will be allowed home, usually three or four hours after the operation. If children need to stay in hospital there are provisions for a parent or carer to stay with them. This will be discussed with you in more detail if necessary.
After squint surgery
After the operation, some children experience a little discomfort, mainly a scratchy feeling, for a day or two, and normal painkillers like paracetamol are helpful. You will also be given eye drops to put in for a couple of weeks afterwards to help healing and to prevent infection. The white of the eye will be quite red and this will take some weeks to fully settle, gradually fading. We usually recommend about a week off school to recover, but your child can use their eyes as normal straight away, and some children are back at school sooner. They can bath or shower next day, although we recommend they try not to get soap or water in their eyes. Light exercise is fine, and we usually recommend no swimming for four weeks after squint surgery.
Risks of squint surgery
Complications from squint surgery are rare, but may include over or under-correction of the squint, double vision (which may or may not settle), or very rarely an infection or inflammatory reaction which would need further treatment. In rare cases, a further operation may be needed if, for example, the muscle were to slip. The risk to your child’s sight is minimal (approx one in 10,000) as the surgeon does not go inside the eye itself.
Some patients require more than one operation before their eyes appear straight – this is quite common if the squint is severe.
A general anaesthetic carries a very slight risk of complications.