Strabismus surgery is performed to re-align the eyes. It is done by weakening, strengthening or transposing one or more of the 6 extraocular muscles responsible for moving the eyes. General anaesthesia is used, with the patient often going home the same day the operation is performed.
The extraocular muscles are attached to the sclera, which is the wall of the eye. During surgery, the eyelids are held open using a speculum, and the muscle to be operated on is approached by first incising the conjunctiva, which is a thin, transparent layer, and then isolated using a small hook. There are no incisions to the skin around the eye, and the eyeball itself is never removed.
The most common procedures are muscle recessions or resections. A recession will weaken the action of the muscle by moving the insertion of the muscle further back from the front of the eye.
A resection strengthens the action of the muscle. The surgeon removes a portion of the muscle and then reattaches the insertion, thereby shortening the muscle and increasing it's function.
Sometimes, adjustable sutures are used in order to finely tune the new alignment of the eyes. This is done by leaving a temporary knot in the muscle and then altering it later in the day or the following day, when the patient is awake. Local anaesthesia is used.
Is it sore?
The eyes can feel gritty and sore, particularly on eye movement, for a few days after the surgery.