Strabismus surgery

Your child's doctor has recommended surgery (an operation) to improve your child's strabismus​.

What happens during strabismus surgery?

Before the surgery, your child will have a special "sleep medicine" called a general anaesthetic. This will make sure your child sleeps through the operation and does not feel any pain.

The surgeon will tighten the weak muscles of your child's eyes and/or loosen the stronger muscles so the eyes are positioned better. Special stitches will hold the eye muscles in their new position. These stitches are absorbable, meaning that they do not need to be taken out. They will dissolve on their own over the first 6 to 8 weeks after surgery.

The surgeon will not cut the skin around your child's eye, take the eye out of its socket, or use any lasers during the operation.

What to expect after your child's strabismus surgery

Eye patch

Your child's eye(s) may be patched after the surgery. If a patch is put on, the nurse usually takes it off before your child is sent home from the hospital. If the patch is needed for a longer time, it is usually for one night. Your child's doctor will tell you when to take it off.

Redness and swelling

Your child's eyes may be red and slightly swollen for several weeks. The redness and swelling should start to decrease after a couple of weeks. If you notice the swelling or redness getting worse after this time, please call your child's doctor.

Pain or discomfort

Your child may have some discomfort or pain in the operated eye. Ask your child's doctor if you can give medicine to relieve the pain or discomfort.

Some doctors will also suggest putting cool water or ice water compresses on the eyes to ease discomfort and reduce the swelling. Ask your child's doctor if your child can have cool compresses.

To make a cool compress, follow these steps:

  1. Always wash your hands before and after you touch your child's eyes.
  2. Fill a clean container with cold water. Cool tap water is fine. If you have well water, boil it and cool it in the refrigerator before you use it. 
  3. Soak a clean face cloth in the water.
  4. Squeeze any extra water out of the cloth, then place the cloth on the swollen eye(s).
  5. Leave the cloth on the eyes for no more than 2 minutes at a time.
  6. Repeat a few times. 
  7. Ask the doctor how often your child can have a cool compress. Several times a day for the first 1 or 2 days is often fine.

Double vision

Your child may see double after the operation. This will almost always go away as the swelling goes down and the child gets used to the new position of the eye muscles. Call your child's eye doctor if your child cannot see as well as he did before or if the double vision does not go away.

Pinkish or light yellow tears

Your child may have small amounts of slightly pinkish tears or blood-tinged discharge from the eyes for a couple of days after the surgery. Your child may also have clear light yellow tears at times.

If the discharge continues after a couple of days or if it becomes bloodier, call your child's eye doctor.

White discharge or mucus

You may also notice that your child has thin whitish discharge or mucus around the eyes, especially after he wakes up from sleep. This is entirely normal as the eyes heal. You can clean away this mucus with a face cloth rinsed in warm water. Put the face cloth on the eyes for 1 to 2 minutes and then gently wipe off the discharge. 

If the discharge is yellow or green, call your child's eye doctor.

The cornea and pupil should look normal

The clear covering of the eye, called the cornea, and the black pupil should always look the way they normally do. If they look different, your child's eye should be checked by an eye doctor.

How to care for your child after the strabismus surgery

Antibiotic and cortisone drops

Sometimes, the doctor will order antibiotic drops or a combination of antibiotic and cortisone drops for the operated eye(s). If your child needs eye drops, your child's doctor will let you know. Please remember to pick up the prescription.

Gentle play only for the first week

For the first week after the surgery, light activities such as gentle playing indoors, using computers, and watching TV are fine. Your child will need to avoid rough activities, sandbox play, or contact sports for at least 2 weeks after the surgery. Ask your child's doctor what activities your child is allowed.

Baths and showers

Ask your child's doctor about baths and showers. Some doctors prefer your child to take a bath instead of a shower for the first week after surgery. Please check with your child's doctor if it is fine to wash your child's hair, as the water could run over his eyes.  If you can wash your child's hair, avoid getting soap or shampoo in his eyes. Only wash your child's face with a clean face cloth and water.

School and day care

Generally, children should not go to school or day care for the first 2 days after the surgery. Please check with your child's eye doctor. Tell your child's caregiver or teacher about any activity restrictions.

Swimming

Swimming is normally not allowed for 3 weeks after the surgery. Please check with your child's doctor.

Follow-up appointments after the strabismus surgery

Follow-up appointments are as important as the surgery itself. These appointments are usually scheduled as follows:

  • during the first week after surgery
  • 4 to 6 weeks after surgery
  • 3 to 6 months after surgery.

Check with your child's doctor about when the first follow-up appointment should happen.

Write the date and time of the first appointment here:______________________

Glasses or patching after surgery

If your child needed glasses before surgery, he will most likely still need them after it. While surgery will help straighten your child's eyes, it is only one part of the treatment. Surgery alone is not a complete cure for every child. Sometimes, an eye will also need "patching" after an operation.

If your child's eye needs patching, your child's doctor will tell you and give you the instructions.

If you have any questions or concerns, please call the doctor who operated on your child's eyes.

Write down your child's doctor's name and phone number here:

Name:  ________________________________

Phone number: __________________________

Key points

  • Strabismus surgery involves tightening the weak muscles and/or loosening the stronger ones so that the eyes are positioned better.
  • Your child's eye may need to be patched after surgery.
  • Your child's eye(s) will be swollen and red after the surgery. Your child might also have double vision, pinkish or light yellow tears, and white mucus around the eye.
  • Call your child's doctor if the swelling does not go away or the redness gets worse, if the double vision does not go away, if there is any yellow or green discharge from the eye, or if the cornea or pupil look different than normal.
  • Follow-up appointments are very important. Be sure to check with your child's doctor about when these should happen. 

At SickKids:

Every eye doctor has their own instructions for what to do after strabismus surgery. Please make sure you receive a copy of your doctor's instructions from your doctor's co-ordinator.

Yasmin Shariff, RN

Stephen Kraft, MD, FRCSC

Nasrin Najm-Tehrani, MD, FRCSC

Kamiar Mireskandari, MD, FRCSC

5/30/2012




Notes: