Squint surgery, also referred to as strabismus surgery, is performed to correct the misalignment of the eyes. Strabismus occurs when the eyes fail to align properly, causing them to point in different directions. In this condition, one eye may look straight ahead while the other turns inward, outward, upward, or downward. This misalignment can impact both vision and depth perception.
Indications for Squint Surgery
Cosmetic Reasons: To enhance the appearance of eye alignment.
Functional Reasons: To restore binocular vision, improve depth perception, and reduce or eliminate double vision (diplopia).
Types of Strabismus
Esotropia: Inward turning of the eye.
Exotropia: Outward turning of the eye.
Hypertropia: Upward turning of the eye.
Hypotropia: Downward turning of the eye.
Preoperative Evaluation
Comprehensive Eye Exam: Assesses the type and degree of strabismus and overall eye health.
Vision Assessment: Determines visual acuity in each eye.
Binocular Vision Testing: Evaluates how well the eyes work together.
Imaging Tests: CT or MRI may be required in some cases.
Surgical Procedure
Anesthesia: Generally performed under general anesthesia, especially in children; local anesthesia with sedation may be used for adults.
Incision: Small incisions are made in the conjunctiva to access the eye muscles.
Muscle Adjustment:
Recession: Detaching and reattaching the muscle further back to weaken it.
Resection: Removing a portion of the muscle and reattaching the shortened muscle to strengthen it.
Other Techniques: Techniques like adjustable sutures may fine-tune alignment during or after surgery.
Closing the Incision: Conjunctival incisions are usually closed with dissolvable sutures.
Recovery
Immediate Post-Op: Mild discomfort, redness, and swelling may occur. Pain is generally mild and manageable with over-the-counter pain relievers.
Activity Restrictions: Avoid strenuous activities, swimming, and rubbing the eyes for a few weeks.
Medications: Prescribed antibiotic and anti-inflammatory eye drops prevent infection and reduce inflammation.
Follow-Up Visits: Monitor healing and adjust treatment as needed. Adjustments to the eye muscles may be made if adjustable sutures were used.
Potential Complications
Infection: Rare but possible; managed with antibiotics.
Overcorrection or Undercorrection: May require additional surgery.
Double Vision: Usually temporary but can persist.
Scarring: Minimal and typically not visually significant.
Anesthesia Risks: Risks associated with anesthesia, particularly in children.
Long-Term Outlook
Visual Improvement: Significant improvement in eye alignment and binocular vision for many patients. Glasses or prisms may still be needed.
Follow-Up Care: Regular eye exams to monitor alignment and vision. Additional treatments like patching or vision therapy may be necessary.
Strabismus surgery can significantly enhance both the cosmetic appearance and functional vision of individuals with misaligned eyes. The specific approach and outcomes vary depending on the type and severity of strabismus. Consultation with a pediatric or adult strabismus specialist is essential for personalized treatment planning.