Our Summary

This study looked at the rates of strabismus (a condition where the eyes don’t line up properly), strabismus surgery, and reoperations for strabismus surgery in the US, using data from the IRIS (Intelligent Research in Sight) Registry. Out of over 30 million patients, 2.75% were diagnosed with strabismus, with a slightly higher rate in males than females. Strabismus surgery was performed on 0.13% of the patients during the four-year period. The rate of surgery was highest in children up to 5 years old (1.99%) and lowest in adults over 40 (0.05%). Different types of surgical procedures were performed, with horizontal surgeries being the most common. Adjustable sutures were used in 7.42% of cases. The rate of having a repeat operation within a year of the first surgery was 6.72%, and this rate increased with the patient’s age. The study concluded that strabismus is not a common diagnosis in eye care, and only about 1 in 750 patients in the registry had strabismus surgery over the four years. However, 1 in 15 patients needed a repeat operation within a year of the first surgery. This ‘big data’ from the registry can help improve medical practice and training programs.

FAQs

  1. What percentage of patients were diagnosed with strabismus in the IRIS Registry study?
  2. What was the most common type of surgical procedure performed for strabismus?
  3. What was the rate of repeat operations within a year of the first strabismus surgery according to the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about strabismus surgery is to follow the post-operative care instructions carefully to ensure the best outcome. This may include using prescribed eye drops, avoiding activities that could strain the eyes, and attending follow-up appointments with the doctor. It’s also important to communicate any concerns or changes in vision to the doctor promptly. Additionally, patients should have realistic expectations about the results of the surgery and understand that it may take time for the eyes to fully align.

Suitable For

Patients who are typically recommended strabismus surgery include:

  1. Children up to 5 years old: The study found that the rate of strabismus surgery was highest in this age group, likely due to the importance of correcting strabismus early in life to prevent long-term vision problems.

  2. Patients with significant misalignment of the eyes: Surgery may be recommended for patients with severe strabismus that cannot be corrected with other treatments such as glasses, vision therapy, or eye patches.

  3. Patients with symptoms such as double vision, headaches, or difficulty with depth perception: These symptoms can significantly impact a patient’s quality of life and may warrant surgical intervention to correct the underlying eye misalignment.

  4. Patients who have not responded to other treatments: If other non-surgical treatments have been unsuccessful in correcting the strabismus, surgery may be recommended as a last resort to improve the alignment of the eyes.

  5. Patients with a history of strabismus reoperation: The study found that a significant number of patients required a repeat operation within a year of their first surgery, indicating that some patients may need multiple surgeries to achieve the desired alignment of the eyes.

Overall, the decision to recommend strabismus surgery is based on a variety of factors, including the severity of the eye misalignment, the presence of symptoms, and the patient’s response to other treatments. It is important for patients to consult with an ophthalmologist who specializes in strabismus to determine the most appropriate treatment plan for their individual case.

Timeline

Before strabismus surgery:

  • Patient experiences symptoms of misaligned or crossed eyes, double vision, or difficulty focusing
  • Patient consults with an ophthalmologist or eye specialist for evaluation
  • Ophthalmologist conducts a thorough eye examination to determine the type and severity of strabismus
  • Ophthalmologist discusses treatment options, including non-surgical methods such as eye exercises, prism glasses, or botox injections
  • If surgery is recommended, patient undergoes pre-operative testing and evaluation to assess overall eye health and readiness for surgery

After strabismus surgery:

  • Patient undergoes the surgical procedure to correct the alignment of the eyes
  • Patient may experience some discomfort, redness, or swelling in the eye area immediately after surgery
  • Patient is monitored closely by the ophthalmologist for any signs of complications or side effects
  • Patient may be prescribed eye drops or medications to aid in healing and prevent infection
  • Patient will need to follow post-operative care instructions, including avoiding strenuous activities, keeping the eye area clean, and attending follow-up appointments with the ophthalmologist
  • Patient may need to undergo vision therapy or rehabilitation to strengthen eye muscles and improve coordination between the eyes
  • Patient may experience improved vision and alignment of the eyes, leading to better depth perception and overall visual function.

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 in correcting the misalignment of the eyes?
  3. How long is the recovery period after strabismus surgery?
  4. Will I need to wear an eye patch or use eye drops after surgery?
  5. Will I need to follow up with the surgeon for post-operative care?
  6. Are there any alternative treatments to strabismus surgery that I should consider?
  7. How many strabismus surgeries does the surgeon perform in a year?
  8. What is the experience and success rate of the surgeon in performing strabismus surgery?
  9. Are there any specific pre-operative instructions or preparations I need to follow before the surgery?
  10. How soon after strabismus surgery can I expect to see improvements in my eye alignment?

Reference

Authors: Repka MX, Lum F, Burugapalli B. Journal: Ophthalmology. 2018 Oct;125(10):1646-1653. doi: 10.1016/j.ophtha.2018.04.024. Epub 2018 May 18. PMID: 29779683