Our Summary

This paper is about how to plan for strabismus surgery, which is a procedure to correct misalignment of the eyes. The article outlines the steps for this plan and explains the thought process behind each case to help choose the best surgical approach. It uses clinical examples to illustrate the planning process, and emphasizes the importance of using preoperative pictures to document the eye alignment before and after surgery.

Three strabismus cases are reviewed, highlighting key factors to consider when planning the surgery such as the patient’s visual acuity, refractive error, potential for stereovision (depth perception), and risk of postoperative diplopia (double vision). The most important factor, however, is accurate orthoptic measurements (measurements of eye movements and positions).

The paper concludes that careful preoperative planning can improve the results of strabismus surgery. By spending time reflecting on the surgery plan beforehand, the surgeon can anticipate potential issues and avoid them during the actual surgery.

FAQs

  1. What is the primary purpose of preoperative planning in strabismus surgery?
  2. What are some of the key factors to consider when planning for strabismus surgery according to the paper?
  3. How does preoperative planning help improve the results of strabismus surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about strabismus surgery is to follow all preoperative instructions carefully. This may include stopping certain medications, fasting before surgery, and avoiding contact lenses. By following these instructions, the patient can help ensure the best possible outcome and minimize the risk of complications during and after the surgery.

Suitable For

Patients who are typically recommended for strabismus surgery are those who have persistent misalignment of the eyes that cannot be corrected with non-surgical methods such as glasses, prisms, or vision therapy. These patients may experience symptoms such as double vision, eye strain, headaches, or social stigma due to their eye misalignment.

Children with strabismus may also be recommended for surgery if their eye alignment is affecting their visual development, such as causing amblyopia (lazy eye). In these cases, early intervention with surgery may be necessary to prevent permanent vision loss.

Adults with strabismus may also be candidates for surgery if they are bothered by the appearance of their eyes or are experiencing symptoms such as double vision. The decision to undergo surgery in adults is often based on the impact of the eye misalignment on their quality of life.

Overall, the decision to recommend strabismus surgery is based on a combination of factors including the severity of the eye misalignment, the presence of symptoms, the potential for improvement with surgery, and the patient’s overall health and visual status. It is important for patients to undergo a comprehensive evaluation by an ophthalmologist specializing in strabismus to determine if they are a suitable candidate for surgery.

Timeline

Timeline before strabismus surgery:

  1. Initial consultation with an ophthalmologist or strabismus specialist to discuss the patient’s symptoms and medical history.
  2. Comprehensive eye examination to determine the extent of eye misalignment and assess the patient’s visual function.
  3. Orthoptic assessment to measure eye movements, alignment, and coordination.
  4. Discussion of treatment options, including the possibility of surgery, with the patient and their family.
  5. Preoperative testing, such as blood tests and imaging studies, to ensure the patient is medically fit for surgery.
  6. Preoperative counseling to address any concerns or questions the patient may have about the procedure.

Timeline after strabismus surgery:

  1. Recovery period immediately following surgery, during which the patient may experience discomfort, swelling, and blurred vision.
  2. Postoperative follow-up appointments with the surgeon to monitor the healing process and assess the alignment of the eyes.
  3. Rehabilitation therapy, such as eye exercises or patching, to help the eyes work together and improve visual outcomes.
  4. Monitoring for any complications or side effects, such as double vision or recurrence of eye misalignment.
  5. Long-term follow-up to ensure the success of the surgery and address any ongoing issues or concerns.

Overall, the timeline for strabismus surgery involves thorough preoperative planning, careful execution of the procedure, and comprehensive postoperative care to achieve the best possible outcome for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about strabismus surgery include:

  1. What are the potential risks and complications associated with strabismus surgery?
  2. What is the success rate of strabismus surgery in correcting eye misalignment?
  3. How long is the recovery process and what can I expect during the postoperative period?
  4. Will I need to wear an eye patch or use eye drops following the surgery?
  5. How soon after the surgery will I be able to resume normal activities, such as driving or working?
  6. Are there any alternative treatment options to consider before undergoing strabismus surgery?
  7. Will I need to undergo additional procedures or follow-up appointments after the surgery?
  8. What are the potential long-term effects of strabismus surgery on my vision and eye alignment?
  9. Can you provide me with before-and-after photos of previous patients who have undergone strabismus surgery?
  10. What is your experience and success rate with performing strabismus surgery?

Reference

Authors: Aroichane M. Journal: Am Orthopt J. 2016 Jan;66(1):63-78. doi: 10.3368/aoj.66.1.63. PMID: 27799579