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Eye muscle repair

Repair of cross-eye; Resection and recession; Strabismus repair; Extraocular muscle surgery

Eye muscle repair is surgery to correct eye muscle problems that cause strabismus (crossed eyes).

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Walleyes
Before and after strabismus repair

Presentation

Eye muscle repair - normal anatomy

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Description

The goal of this surgery is to restore the eye muscles to a proper position. This will help the eyes move correctly.

Eye muscle surgery is most often done on children. However, adults who have similar eye problems may also have it done. Children will most often have general anesthesia for the procedure. They will be asleep and will not feel pain.

Depending on the problem, one or both eyes may need surgery.

After the anesthesia has taken effect, the eye surgeon makes a small surgical cut in the clear tissue covering the white of the eye. This tissue is called the conjunctiva. Then the surgeon will locate one or more of the eye muscles that needs surgery. Sometimes the surgery strengthens the muscle, and sometimes it weakens it.

The surgery for adults is similar. In most cases, adults are awake, but are given medicine to numb the area and help them relax.

When the procedure is done on adults, an adjustable stitch is used on the weakened muscle so that minor changes can be made later that day or the next day. This technique often has a very good outcome.

Why the Procedure Is Performed

Strabismus is a disorder in which the two eyes DO NOT line up in the same direction. Therefore, the eyes DO NOT focus on the same object at the same time. The condition is more commonly known as "crossed eyes."

Surgery may be recommended when strabismus does not improve with glasses or eye exercises.

Risks

Risks for any anesthesia are:

Risks for any surgery are:

Some risks for this surgery include:

Before the Procedure

Your child's eye surgeon may ask for:

Always tell your child's health care provider:

During the days before the surgery:

On the day of the surgery:

After the Procedure

The surgery does not need an overnight stay in the hospital most of the time. The eyes are most often straight right after surgery.

While recovering from the anesthesia and in the first few days after surgery, your child should avoid rubbing their eyes. Your surgeon will show you how to prevent your child from rubbing their eyes.

After a few hours of recovery, your child may go home. You should have a follow-up visit with the eye surgeon 1 to 2 weeks after the surgery.

To prevent infection, you will probably need to put drops or ointment in your child's eyes.

Outlook (Prognosis)

Eye muscle surgery does not fix the poor vision of a lazy (amblyopic) eye. Your child may have to wear glasses or a patch.

In general, the younger a child is when the operation is performed, the better the result. Your child's eyes should look normal a few weeks after the surgery.

Related Information

Strabismus
Conjunctiva
Eye muscle repair - discharge

References

Coats DK, Olitsky SE. Strabismus surgery. In: Lambert SR, Lyons CJ, eds. Taylor & Hoyt's Pediatric Ophthalmology and Strabismus. 5th ed. Philadelphia, PA: Elsevier; 2017:chap 86.

Olitsky SE, Hug D, Plummer LS, Stahl ED, Ariss MM, Lindquist TP. Disorders of eye movement and alignment. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 623.

Robbins SL. Techniques of strabismus surgery. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 11.13.

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Review Date: 8/28/2018  

Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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