Adult Strabismus Surgery

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What is this information about?

This information is about having strabismus surgery. This is surgery that helps the eyes work more easily together.  

It tells you what the surgery is for, why you may need it, and what happens during and after your surgery. This includes cleaning and looking after your eye, or eyes, when you are at home. 

Why have I been given this information?

You have been given this information because you, a family member, or someone you are a carer for, is going to have adult strabismus surgery.  

Reading this information will help you to know what to expect from the surgery, any risks, and how you will recover.  

What is a strabismus?

Strabismus is the term used to describe eyes that are not pointing in the same direction and not working together.  

You may have strabismus all of the time, or just sometimes. It may be only in one eye or may change between the two eyes. 

Strabismus surgery will adjust the muscles in the affected eye to help correct this. 

Why do I need an operation for strabismus?

This depends on the type of strabismus that you have. The aims of surgery should be discussed with the orthoptist (eye doctor) before your operation.  

The reasons for having surgery include: 

• to improve the cosmetic appearance of the eyes (how they look) 
• to let the eyes to work together more easily  
• to reduce double vision  
• to improve head posture (the way you hold your head).  

What happens before the operation?

• You will be put on a waiting list. We will talk with you about how long your wait will be when this happens.   
• You will receive an appointment to come in for orthoptic measurements up to four weeks before the surgery.  
• You will have a general anaesthetic assessment. 

What are the risks of having this surgery?

Risks include:

• Having a general anaesthetic can be a risk. The anaesthetist will discuss this with you. 
• The surgery may not give you the results that you want (under or over-correction) 
• There is a risk of eye infection after the operation. You will be given eye drops to prevent this. 
• You may notice you have double vision for a short time after the operation. Your orthoptist will talk with you before your surgery about how likely this is.  
• There is a very small risk of visual (sight) loss. This is rare. 

How long will the surgery take, and will I have to stay in hospital overnight?

The procedure usually takes 40 to 90 minutes depending on the surgery involved.  

You will not need to stay in hospital overnight.

What happens during the surgery?

On the day of surgery, you will be seen by: 

• a nurse. They will discuss everything that is going to happen.  
• An orthoptist. They will come to do repeat measurements.  
• An anaesthetist who will explain the anaesthetic procedure.  
• The surgeon. They will explain the risks and benefits of the surgery and complete the consent form with you. 

The surgeon will move the eye muscles on the outer surface of your eye to strengthen or weaken their action. There are six muscles on each eye. The surgeon and the orthoptist will decide which muscles need to be adjusted. This may be on one or both eyes.  

 Your eye is not taken out.  

What happens after the surgery?

Once the operation is over, you will be taken to a recovery room. Once awake, you will need to eat and drink something. You will be given tea or coffee and a biscuit.  

Straight after the operation, your eye, or eyes, will be red and swollen. You may be able to see a small black stitch on the white of the eye. Your eye will feel sore for a few days after the operation and may feel “scratchy”. You can take paracetamol or ibuprofen if you have any pain.  

Before you leave the ward, you will be given a follow-up appointment. You will be prescribed eye drops to reduce inflammation and prevent infection.  

How should I use the eye drops when I get home?

1. Make sure you always wash your hands before touching the eye or putting the drops in.  
2. Tilt your head back and pull the lower eyelid down.  
3. Drop an eye drop onto the inside of the lower eyelid, release the lid and wipe away any excess fluid.  
4. Do not touch the eye with the bottle.  
5. If you are not sure the drop has gone in, it is safe to use another. 

How should I clean my eye?

To clean the eye use cooled boiled water and a small piece of gauze. Wipe outwards from your nose to your temple (the corner of your forehead). Repeat as necessary.  

Use a new gauze swab for the other eye. 

Is there anything I should avoid after my surgery?

Who can I contact for further information and advice?

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