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A patient's guide to eye surgery sponsored by the London Eye Hospital

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London Eye Hospital, a dedicated ophthalmic hospital treating all eye conditions, with state-of-the-art facilities in Harley Street and Wimpole Street.
Eye surgery

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Squint surgery guide

Squint surgery

What is a squint?

A squint, or strabismus, occurs when the eyes do not align properly because one of them turns in or out, up or down, while the other looks straight ahead. In adults, if it occurs due to an accident or illness, it can cause double vision or blurring of vision. Children with a squint can develop a lazy eye because the brain completely ignores input from the out-of-line eye.

Squints affect around 5% of children, and occur most often in their pre-school years. A child can be born with a squint or the condition can develop later as the muscles fail to develop properly, or develop unevenly.

Squint surgery

Squint surgery is used to balance the muscles that control the movement of the eyes. In many cases, the surgeon will need to work on the muscles of both eyes to achieve the best balance.

The selected eye muscles are detached and either shortened, to increase their effect, or moved forwards in the eye socket, to decrease their effect, before being sewn back into place with dissolvable stitches.

Squint surgery is performed under general anaesthetic, and you will normally be able to stay with your child until the anaesthetic takes effect, and return before they wake up, so they will feel like you have been with them throughout.

What to expect after squint surgery

As you would expect, the eye will be sore after squint surgery, and the stitches can feel gritty and irritating. However it is important to stop your child from rubbing their eye during this time if you can. The stitches will dissolve in around six weeks.

There is no need to wear a dressing or eye patch, even if the eye seems red or sore, as it is important to get the eyes working together again as quickly as possible.

Your child should be able to return to nursery or school after about a week, but extra care should be taken for at least a fortnight, including:

  • Avoiding playing in sand or mud.
  • Avoiding getting shampoo in the eyes.
  • Avoiding swimming.
  • Not using face paints.
  • Avoiding sports, especially contact sports, and rough play.

Risks and complications of squint surgery

Squint surgery is a common and routine operation with very few risks. However, as many as 60% of children who have an early operation, around age one, will require a further operation as they get older. In adults, only 20% will require further surgery.

Other risks are rare, but include:

  • Prolonged red eye caused by scar tissue.
  • Double vision for up to a fortnight.
  • A detached muscle that has slipped its stitches, causing the eye to go off line.
  • Damage to the inside of the eye.
  • An infection at the wound site.

Alternatives to squint surgery

Squints should be treated promptly once they have been diagnosed, as the vision problems they cause will only get worse and may become permanent. However, before squint surgery is recommended, your ophthalmologist will try alternative treatments to try and cure the squint. These include:

  • Corrective glasses - to resolve sight problems.
  • Eye exercises - to train the muscles.
  • Botox injections – to rebalance the muscles.

Getting very small children to wear glasses or perform eye exercises can be difficult while Botox treatments may only last a few months before the squint returns. In many cases, surgery is the most effective option.

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