Consenting for your Operation

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This leaflet gives you information you should know before agreeing to undergo surgery. We encourage you to read this and ask any questions which may arise before signing the Consent Form on the day of your surgery.

Benefits

• To improve the appearance of a strabismus, with glasses if worn.
• Reduction in the severity or frequency of double vision, if suffered.
• To improve the control that you have over the strabismus.
• Allowing the eyes to work together as a pair.

Your specific case will be discussed with you in detail as not all these will apply to your condition.

Risks

As with every operation, strabismus surgery has risks.

• All serious complications are rare.
• The main risk is the possibility that the surgery may over correct or under correct your strabismus. This may mean you require further surgery, this may be soon after, or up to many years after the original surgery. Based on prospective audits 90% achieve good functional / cosmetic outcome with one operation.
• The operation may give you double vision. This may occur as the brain adjusts to the new position of the eyes. This often settles over days to weeks. If it is permanent other treatment may be necessary.
• Blurred vision, itchiness and redness is normal immediately after surgery and settles.

Complications during the operation (all very rare)

• One of the eye muscles may slip and be difficult to find during surgery.
• One of the sharp instruments used during the surgery may pierce the wall of the eye. (Globe perforation 0.1% or 1 per 1000* – antibiotics may be required or laser
treatment. Depending on the site of the perforation, eye sight could be affected).
• An incorrect muscle may be operated on because of unusual anatomy or previous
surgery.
• It may not be possible to perform as much surgery as is needed because maximal
surgery has already been performed during a previous operation.

Complications occurring after the operation

• Over or under correction of the squint.
• Double vision which does not settle within a few weeks.
• Inflammation or infection of the eyeball. (Scleritis. This would require additional medication).
• Damage to the sight of the eye: can result from detached retina or infection in the eye (Endophthalmitis: 0.05% or 1 patient per 2000 according to the British Ophthalmic surveillance unit).
• Cyst formation at the site of dissolvable sutures.
• ‘Slipped muscle’. The eye is in a good position after surgery, but then suddenly worsens again in the days following surgery. (0.09% or 1 patient per 1100 according to the British Ophthalmic surveillance unit. Further surgery may be required. Sometimes it is not possible to correct this).
• Anterior Segment Ischaemia (reduced blood flow to the front of the eye) is a risk with multiple previous strabismus surgeries and / or increasing number of muscles being operated on in one eye).
• Overall serious risks occur in 0.3% or 3 patients per 1000 according to the British Ophthalmic surveillance unit.

Alternatives to surgery

Alternatives are available to some patients such as prisms in glasses, regular botulinum toxin injections or use of a special patch or contact lens to block the vision in one eye. These can be discussed with your orthoptist / ophthalmologist.

Useful information

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