Our Summary

This research paper describes two unique cases where a particular eye condition, strabismus (where the eyes don’t perfectly align with each other), was treated through surgery despite not having a clear cause. In these cases, a tissue sample from the eye muscle was taken during the surgery. This allowed the researchers to confirm the diagnosis through studying the tissue under a microscope. The two cases had different underlying conditions: one had Graves’ orbitopathy, a thyroid-related eye disease, and the other had light-chain amyloidosis, a rare disease that leads to abnormal protein accumulation.

FAQs

  1. What is strabismus and how is it typically diagnosed prior to surgery?
  2. What is the purpose of performing an extraocular muscle biopsy during strabismus surgery?
  3. Can strabismus surgery be used to confirm a clinical diagnosis of conditions like Graves’ orbitopathy or amyloid light-chain amyloidosis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about strabismus surgery is to follow post-operative instructions carefully to ensure optimal healing and alignment of the eyes. This may include keeping the eyes clean and avoiding strenuous activities that could strain the eye muscles. Additionally, attending follow-up appointments with the surgeon to monitor progress and address any concerns is important for successful outcomes.

Suitable For

Strabismus surgery is typically recommended for patients who have a significant misalignment of the eyes that affects their vision or causes discomfort. This can include patients with:

  • Congenital strabismus (present at birth)
  • Acquired strabismus (developed later in life)
  • Neurological conditions such as cerebral palsy or brain tumors
  • Thyroid eye disease (Graves’ orbitopathy)
  • Systemic diseases such as amyloidosis

In cases where the cause of the strabismus is unknown or the misalignment is stable, surgery may be recommended to improve the alignment of the eyes and alleviate symptoms such as double vision or eye strain. Patients who have not responded to non-surgical treatments such as glasses, eye exercises, or vision therapy may also be candidates for strabismus surgery.

It is important for patients to undergo a thorough evaluation by an ophthalmologist or strabismus specialist to determine if surgery is the most appropriate treatment option for their specific case.

Timeline

Before strabismus surgery:

  • Patient consults with an ophthalmologist or strabismus specialist to discuss their eye misalignment and potential treatment options.
  • Eye examination and diagnostic tests are performed to determine the cause and severity of the strabismus.
  • Treatment options such as glasses, vision therapy, or botulinum toxin injections may be recommended before considering surgery.
  • If surgery is deemed necessary, the patient will undergo pre-operative testing and evaluations to ensure they are a good candidate for the procedure.

After strabismus surgery:

  • The patient may experience some discomfort, swelling, and redness in the eye area immediately following surgery.
  • The eye may be temporarily patched or covered to protect it while it heals.
  • The patient will be given post-operative instructions on how to care for their eye and manage any discomfort.
  • Follow-up appointments will be scheduled to monitor the healing process and assess the effectiveness of the surgery.
  • Vision may improve gradually over time as the eye muscles adjust to their new alignment.
  • In some cases, additional surgeries or treatments may be needed to further improve the alignment of the eyes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with strabismus surgery?
  2. What is the success rate of strabismus surgery for my specific condition?
  3. How long will the recovery process be, and what can I expect in terms of post-operative care?
  4. Are there alternative treatments or approaches to consider before opting for surgery?
  5. Will I need any additional testing or imaging before undergoing surgery?
  6. How experienced are you in performing strabismus surgery, and what is your success rate?
  7. Can you provide me with information on the specific techniques or procedures you plan to use during the surgery?
  8. How will strabismus surgery affect my vision and overall eye health in the long term?
  9. What can I do to prepare for surgery, and are there any restrictions or guidelines I should follow beforehand?
  10. Are there any lifestyle changes or follow-up appointments I should be aware of after the surgery?

Reference

Authors: Assam JH, Miller AM, Chevez-Barrios P, Lee AG. Journal: J AAPOS. 2019 Dec;23(6):356-359. doi: 10.1016/j.jaapos.2019.09.010. Epub 2019 Nov 1. PMID: 31678481