After my strabismus surgery how long will my
eye be red? Over
the first 2 weeks post surgery most of the redness will clear. There
will be some remaining redness over the area of the sutures until they
are fully dissolved. This will take 6-12 weeks to occur.
Does eye surgery ever cause nausea? Post
surgery there is a risk of nausea. This is best treated with gravol or
similar medications.
How will strabismus surgery affect my
vision? Typically
strabismus surgery itself does not affect the vision of each eye
individually. This surgery will help to better align your eyes.
Children with straighter
eyes will be provided with the
opportunity to learn how to use their eyes
better
together
Adults with straighter eyes may recover
a past ability to use their eyes together.
The
recovery or learning to use both eyes together remains difficult to
quantify. We do know however that the best results are achieved by
aligning the eyes at as young an age as possible.
In addition eye alignment
when the eyes are deviated inwards will
enlarge the visual field to a
more normal range.
I see a little bump on the surface of my eye
after surgery what is it and will it go away? During
the surgery one major stitch (suture) was placed to hold each muscle
that was moved. These sutures will dissolve over a 6-8 week period of
time. Until they have dissolved a bump will be visible. This bump may be
reddish in colour. Time alone is required to allow the sutures to
dissolve and the surface to heal completely.
Were stitches used during my strabismus
surgery? Yes.
During the surgery one major stitch (suture) was placed to hold each
muscle that was moved. These sutures will dissolve over a 6-8 week
period of time. There were also some sutures placed on the surface layer
of the eye (conjunctiva). These were placed to help keep all tissues in
the best possible position for healing to provide the best post
operative appearance.
What is the black or purple dot on my eye
after strabismus surgery? These
dots are the sutures placed at the time of surgery. They will dissolve
or fall out over 2-12 weeks post surgery.
What should I avoid after strabismus
surgery? It is
most important to keep the eyes clean for 2-4 weeks post strabismus
surgery. This will allow for proper healing and help to prevent infection.
We suggest staying out of dirty areas such as
swimming pools for a minimum of 2 weeks following surgery. Goggles can
then be used for an additional 2 weeks
You may go for a walk or resume most regular
activities within a few days of surgery, but avoid very heavy lifting or
vigorous activities
For runners, take it easy the first week with
brisk walks, go at 50-60% or usual running the second week and then
return to normal the third week
What type of pain killers are needed after
strabismus surgery? On
the day of surgery you will be given pain killers at the hospital. After
going home most people feel that Acetaminophen (Atasol, Tylenol etc.) is
usually sufficient. A cold cloth or even an ice pack used a few minutes
on then a few minutes off helps to maintain comfort for a few days after
surgery. It is best to avoid ASA or aspirin type preparations as they
can lead to further bleeding.
When can I return to work or school after
strabismus surgery? Typically
after strabismus surgery students should stay home for
4-7 days. They may
then return to school but must stay out of swimming pools, and dirty
places, adn off Gym for an additional 2-3 weeks. They may then resume all activities.
ADULTS: must similarly keep the eye area clean for 2-3 weeks. Thus
the patients return to work depends on the type of work
they perform. If you wish to do paper
work, reading or anything clean you may return to it as soon as you feel
well enough. Typically this is 3-14 days. For extremely dirty
environments 3-4 weeks off work is suggested.
When should I be concerned about discharge? If
there is a very greenish discharge, especially if associated with a big
change in vision, significant worsening of pain, or redness you should
call the office and be rechecked as soon as possible.
When can I expect my eyes to reach their
best position after strabismus surgery? Often
we can get a good idea of the eye position within 1 month of surgery.
Healing does continue and the eye position may continue to shift for a
year (or in some cases) more after surgery.
Will I require additional surgery for my
strabismus? Eye
movements are initiated in the eye movement centers of the brain, then
travel along nerves to the eye muscles. When any part of the system is
not working correctly strabismus occurs. As you can imagine this is an
extremely complex system. Prior to your surgery we measure the eye
deviation, and using that along with your medical history
we will determine
the best treatment. In
most cases we are quite accurate and get the eyes 80-90% straighter. At
times when we are not as accurate as we wish, and we over or under
correct the eye position, we may end up with a residual strabismus. We
then continue as we do with all cases after surgery by following and
measuring your eye deviation. If we find that the deviation remains
significant and we feel after discussing this together that we have a
high chance to improve the eye position further we may consider further
surgery. In
all cases we will discuss in detail the risks and benefits of surgery
with you prior to your surgery. We will work as a team and
want you to play an active role in your or your Childs care.
Will there be bleeding after my strabismus
surgery? Often
there will be some bleeding the day of surgery. Occasionally (especially
in complex and re-operative cases) the bleeding may continue for a few
days after surgery. This is not dangerous and will clear with time. You
may also expect some yellow mucous discharge due to the irritation from
the sutures. This may continue for 3-5 days post surgery. Just take a
cloth, gauze, or cotton ball with some warm water to clear it away.
What is the
effect of botulinum toxin? The
effect of botulinum toxin is to cause a paralysis of the muscle into
which it has been injected.
How
long has it been in use? Botulinum
toxin was introduced for the treatment of Squint in 1979
Will
it affect my general heath? The
treatment is perfectly safe and there is no risk to general health. In
particular, there is no risk of developing botulism or food poisoning.
There is no known risk when the treatment is given to women who are
pregnant or breastfeeding, but some patients prefer to postpone
treatment until this is over.
Who will I see
when If attend the clinic? To
begin with, you will have an examination by an orthoptist. Then you will
see the consultant ophthalmologist (Dr. Budning). If the treatment is
suitable for you, all risks and benefits will be reviewed
with you and an
appointment for Botulinum toxin injection will be arranged.
What is the
procedure for the treatment? You
will be given local anesthetic drops to numb the eye. These drops are
very effective in taking away the surface sensation of the eye, but you
should note that there will still be some discomfort as the injection is
given, especially if you have scar tissue around the muscle from
previous surgery. You will then have some wires attached to your
forehead. These will be attached to an amplifier and loudspeaker, to
allow the injection to be given exactly into the muscle, by monitoring
the electrical activity of the muscle. You will hear this through the
loudspeaker during the injection.
What happens
when I have had the injection? You
will be asked whether you prefer a pad on the eye, or to wear your own
glasses. The eye is numb after the drops, and should be protected for
about 2 hours in case something blows into the eye without your
knowledge. You may feel an ache in the eye after injection. If that is
not better in an hour, take whatever medication you would usually take
for a headache.
When should I
expect to see an effect from the treatment? The
effect is usually noticed about 2 days after the injection is given.
How long does
the effect last? This
varies a lot, but it usually lasts for weeks, occasionally months, but
then will wear off. To begin with, you may notice a temporary reversal
of the squint, followed by gradual straightening of the eyes as the
paralysis wears off.
What are the
possible side-effects? Temporary
reversal of the direction of the squint. Temporary double vision. If
this is significant and bothersome you should not drive unless you cover
one eye. Temporary drooping of the eyelid on the injected side
(for up to 3-4 weeks). This
typically resolves after a few weeks. Slight bruising on the surface of
the eye or within the eyelid may occur. All these will get better without further treatment.
When do I
return to the clinic? We
like to see all our new patients one or two weeks after the injection.
If the first injection did not produce an adequate effect, we may offer
a repeat injection at that visit.
Other important information. If
you have any reason to believe that you may be a carrier of hepatitis or
HIV virus, please make sure that you tell the doctor who sees you in the
clinic. The information is confidential, but it is essential that we are
informed.
We
dispose of all injection needles after one use, so there is no risk of
cross-contamination or infection.
If you
are not clear about any aspect of this treatment, please ask the doctor
for an additional explanation.
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