Our Summary

This study is focused on a condition called internuclear ophthalmoplegia (INO), which often leads to exotropia (XT), a condition where one or both eyes turn outward. Treating XT in INO patients is challenging. The researchers looked back at the medical records of seven patients with INO who had undergone eye muscle surgery to correct XT from 1995 to 2021. They looked at a variety of factors before the surgery, like the patients’ age, sex, cause of INO, alignment of their eyes, etc. They also studied the type of surgery performed, follow-up surgeries, alignment of the eyes after surgery, and whether the patients still experienced double vision.

They found that different surgical approaches were used - some patients had surgery on one eye muscle, others on two, three, or even four muscles. The surgery helped to correct the eye alignment to a certain extent - the more muscles operated on, the greater the correction. However, three patients needed additional surgery. At the final check-up, patients’ eye alignment ranged from one eye turning inward to turning outward, with an average alignment close to normal. Almost all patients reported relief from double vision, and all showed some improvement in their eye movements.

In summary, the study suggests that surgery on the eye muscles can help many cases of XT in INO. The researchers advise surgeons to consider the cause of INO and any other eye deviations before deciding on surgery. They also found that the extent of the eye movement limitation before surgery is an important factor, but it doesn’t always determine the final outcome.

FAQs

  1. What is the primary focus of this study about strabismus surgery?
  2. What factors did the researchers consider before and after the surgery in patients with internuclear ophthalmoplegia (INO)?
  3. Did the study find that eye muscle surgery was effective in treating exotropia (XT) in patients with INO?

Doctor’s Tip

One helpful tip a doctor might tell a patient about strabismus surgery is to follow all post-operative care instructions carefully. This may include using prescribed eye drops, wearing an eye patch as instructed, and attending follow-up appointments to monitor progress. It is also important to be patient and give the eyes time to heal and adjust after surgery. Additionally, it is important to communicate any concerns or changes in vision to the doctor promptly.

Suitable For

Patients with internuclear ophthalmoplegia (INO) who have exotropia (XT) are typically recommended strabismus surgery. These patients may have difficulty with eye movement coordination due to damage in the brainstem, leading to the eyes not aligning properly. Strabismus surgery can help correct the misalignment of the eyes and improve double vision in these patients. Surgeons may consider factors such as the cause of the INO, the extent of eye deviation, and the number of eye muscles that need to be operated on before recommending surgery. It is important for patients with XT in INO to consult with an eye specialist to determine if strabismus surgery is a suitable treatment option for their condition.

Timeline

Before strabismus surgery, a patient typically experiences symptoms such as misaligned eyes, double vision, or difficulty focusing. They may undergo a thorough eye examination, including tests to assess eye movement and alignment. The ophthalmologist will discuss the surgical procedure, potential risks, and expected outcomes with the patient.

After strabismus surgery, patients may experience some discomfort, redness, or swelling in the eye area. They will be advised to use prescribed eye drops and follow post-operative care instructions. Over the following weeks, the eyes may gradually align, and any double vision or other symptoms may improve. Follow-up appointments will be scheduled to monitor progress and make any necessary adjustments.

Overall, the goal of strabismus surgery is to improve eye alignment and function, leading to better vision and quality of life for the patient.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with strabismus surgery for my specific condition?
  2. What is the success rate of strabismus surgery for patients with internuclear ophthalmoplegia (INO)?
  3. How many muscles will be operated on during the surgery, and how does this affect the outcome?
  4. Will I need additional surgeries after the initial strabismus surgery?
  5. What is the expected alignment of my eyes after the surgery, and how long will it take to see improvement?
  6. Will I still experience double vision after the surgery, and if so, how can it be managed?
  7. How long is the recovery period, and what can I expect in terms of post-operative care and follow-up appointments?
  8. Are there any alternative treatments or therapies for my condition that I should consider before opting for surgery?
  9. How experienced are you in performing strabismus surgery for patients with INO, and what is your success rate?
  10. Are there any lifestyle changes or precautions I should take after the surgery to maintain the results?

Reference

Authors: Nelson DG, Peragallo JH. Journal: Strabismus. 2022 Jun;30(2):65-71. doi: 10.1080/09273972.2022.2061528. Epub 2022 Apr 19. PMID: 35438603