multiple strabismus surgeries

This question came in from Darlene.  -Ann Z

My son had surgery to correct his exotropia but it hasnt seemed to help straighten his eye.  Does anyone have any experience with their child needing multiple strabismus surgeries?

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13 responses to “multiple strabismus surgeries

  1. Our daughter had strabismus surgery at 9 months old and will need a second surgery sometime soon (she is 3 now). Initially, the surgery straightened both eyes, but two weeks after surgery the left eye started turning in again and she got her first pair of glasses. I have heard that especially with congenital esotropia (which is what our daughter has), it is common that strabismus surgery has to be repeated more than one time. When we got all the information before surgery, the doctor told us that there is only a 70% success rate for strabismus surgery, which leaves a large margin of error. It is also common that as the child grows, so can the eye alignment change and require another surgery. It also depends on how complicated the eye turn is. I don’t know what your son’s situation is, but from our experience, it is most important that he has equal vision in both eyes with correction (if necessary). The eye turn can be corrected at any age, but vision is very hard to improve after age 10. If your son has amblyopia because of the eye turn, I would highly recommend to get his vision to be equal to the stronger eye first (with patching and/or vision therapy) before attempting a second surgery because once the weaker eye becomes as strong as the better eye, it can correct the eye turn. I am just a parent not a doctor or an expert, but this is what I have learned from dealing with strabismus in our daughter.

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    • Thank you for your response. Its helpful to know that other people are experiencing similar situations. My son got glasses at 4 months to correct his myopia. We also started patching his eye 3, then 4 hours a day. After those things didnt work to align the eyes the PO discussed surgery. We are still patching 4 hours a day and having him wear his glasses, now with a stronger prescription. The PO made it sound like the younger he had surgery the better. Is that what your PO tells you also?

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      • Yes. It seems that this is the general consensus among POs that the sooner they have strabismus surgery, the better the chances of the brain correcting itself to recognize that there are two eyes with two images that form binocular vision. However, I have heard a lot of other, conflicting believes among POs in other countries. It is extremely frustrating that there is so little research out there especially for congenital strabismus and the best treatment and outcome. It sounds like we are in a very similar situation. We started patching at four months old and haven’t stopped since. Our last PO told us that we would be patching until our daughter turns ten and the eyes are fully developed. THis PO also told us that there is basically no chance that she would ever have binocular vision. That’s very discouraging! We didn’t get glasses until after the surgery at nine months old. However, we have seen very little improvement in her vision with all the patching and glasses until we started vision therapy because I refused to believe that there is nothing that I can do to help our daughter achieve binocular vision. It is very time consuming and expensive, but, if it means that she will be able to see clearly, it is totally worth it. It would be nice to be able to know that if we need another surgery that this will fix the eye turn completely, and it won’t need to be repeated again. However, there is no PO that can give such a guarantee. I know it is hard to know what is best and whose opinion to believe, but you are your son’s best advocate, and you have the right to get as many opinions you can get before putting him through another surgery. How old is your son now? All the best to you and your son! I know you will make the best decision for the best possible outcome.

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  2. hi there, our 22 month old daughter has intermittent exotropia. She has been wearing glasses almost a year and is patching two hours per day which is going very well. The glasses keep the eye that turns out intermittently straight. When they are off, the eye does turn out slightly when she is looking in the distance. However as Corrie mentioned, the PO said that it was most important to get the vision equal in both eyes before any surgery if needed. Our PO seems to think that there is only a very slim chance of Paris needing surgery. He said that as the eye strengthens and the vision equalises over time the eye will straighten out. She will have to wear her glasses still and it may drift a little if she is very tired, but I can deal with that! He also said as children get older and have more control over their eyes and with a little vision therapy she should be able to keep it straight herself. Just my two cents worth! At first I almost wanted the surgery to just fix it now! but I have learned that this is not something that can be fixed overnight it is a long process and only time and persistance will make a difference. It is worth all the hard work though as Paris’s eye is definitely getting stronger and staying straighter more of the time. We are very happy. 🙂

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    • Hi there,

      I saw your post and wanted to reach out for support.

      I just noticed my 14 month daughter’s eye wandering when she was sick. I am sick to my stomach that she has exotropio and am scheduled to see a pediatric ophthalmologist soon…
      In the meantime, I have been going online and only learn that there is no permanent fix and I am so scared.

      May I ask how your daughter is doing? I hope she is well.

      Thank you,
      Helen

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  3. Hi Darlene,
    Our daughter also has myopia and as much as I was optimistic in my last pos I still do notice the eye turning with the glasses on which I know can be an indication for surgery? I see the PO on Monday so will know more as we have been patching for six weeks two hours a day since we last saw him. PAris sounds similar to your son as our daughter has intermittent exotropia due to myopia – one eye only. I only noticed it starting to turn out slightly at around 1o or 11 months, before that it was perfectly straight. I am so worried to be honest as I am worried about surgery but even more worried that if we do have to go down that path, which we may well have to do, that it doesnt work. Can I ask what is your son’s script? Paris is -4 in her myopic eye, plano in the other. So encouraging to know there are others going through the same situation and I feel your pain and worry. Many thanks. Ingrid

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  4. Hi there Ingrid. My sons prescription is quite mild from what I understand. Currently it is -2.75 in the right and -2.25 in the left eye. He has quite a bit of astigmatism as well as something called Brown’s syndrome. Has your PO checked your daughters eyesight recently? I have heard that when young children grow, their eyes grow and change shape causing their prescription to change often. When they cant see as well due to an outdated script then the eye starts drifting again. My sons right eye has gotten progressively worse since the last appt with the PO but I am hoping a new prescription will help with this. Best of luck!

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  5. Has anyone tried vision therapy after a surgery to correct strabismus? If so, how old was your child? Thanks, Darlene

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  6. Hi eveyone,

    my son was born with a severe strabismus condition. He got operated three times (at 1, 18 months and 7 ). He is always patching the right eye because the vision is not that good. the doctors says he cannot improve anymore after 3 operations. when he is tired his eayes are not straight. I have read some interesting tips and consequences on an article. it is really interesting.
    http://ourkidsguide.blogspot.com/

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    • Welcome Olfa,
      How frustrating to have to watch your son go through the three surgeries. I hope that your son’s vision continues to improve with patching.

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      • Hi Ann Z,

        It is quite painful to see my son go through so much surgeries. The last surgery, I was really reluctant it about. I did not want it but I am gald we did it. His vision really improved. But there are other things that we have to work on : like his hand writing, his walking…

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  7. We were told that there is a chance the kids have to go in soon after the first time for a “touch up” as the proceedure is based on measurements, but all bodies react differently. Additionally, it was explained to us that as her eyes grow and change, there may be a need to have surgery again in the future.

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  8. OMG!!! Wait Please! My daughter is 5 years old now at age 1 we noticed her eyes were turning outward more and more so we saw a eye doctor who told us she needed surgery. At the urging of my mother and my own concerns we decided to get a second and third opinion. Anyway all three eye specialist said the same even though her vision seemed good. We preceded with the surgery . It made her vision worst and instead of the occasional turning outward she was completely crossed due to over correction. Second surgery one eye perfect one now. Third surgery she had to hold her head up to focus now we have to have another surgery so we are talking number four. What my poor child……

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