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What is a squint?

A squint occurs when the eyes are not aligned properly. One eye may turn inwards, outwards, up or down. When this happens, the eyes no longer work as a pair. It may happen at any age, but if it happens in children below the age of 6 and remains untreated, it may lead to one eye losing vision and becoming 'lazy'. A child is never too young to be examined or to start treatment. If one eye has been found to be lazy, the good eye may be patched to get the lazy eye to work harder. This is only effective in children. A squint may also affect the ability to use the eyes together and reduce 3 D vision / depth appreciation.

Why is surgery sometimes recommended?

Surgery aims to realign the eyes. This can help restore the ability to use the two eyes together and to improve the vision in the lazy eye. Surgery may also be recommended for cosmetic reasons or if a child is being teased about their appearance. Unfortunately, the vision is sometimes difficult to restore and one eye is left weaker than the other. In children after surgery, patching is sometimes continued to make the vision as good as possible.

What happens at the time of surgery?

Surgery is carried out under general anaesthetic. You will be admitted usually as a day case but you may be offered a hospital bed for the night. During surgery, the skin which covers the eye (conjunctiva) is cut and some of the muscles which move the eye are located. The muscles are detached from the eye and reattached with stitches in a different position. This has the effect of altering the position of the eye. The skin of the eye is then stitched closed using a very fine suture which dissolves on its own and does not need to be removed. Some ointment may be inserted and a pad may be placed on the eye after the operation.

What to expect after surgery

Once your eye pad has been removed, you will notice that the eye is red. You may also have a mucous discharge from the eye and the vision may be slightly blurred. Gently clean away any discharge or dried blood from the eye taking care not to touch the eye itself. The eye may feel slightly sore, this should settle over the first few days. Occasionally in the first few days after squint surgery you may get some double vision. You will have been prescribed some anti-inflammatory drops to put in the eye, please use these as prescribed.

Complications of surgery

All patients undergoing squint surgery have the possibility of needing more than one operation to correct their squint. The eye may be in an unsatisfactory position after the initial surgery. In some cases it is impossible to fully correct the deviation of the eyes and the best that can be achieved is an improved cosmetic appearance.

Bleeding and bruising The eye may remain red for a few weeks after surgery but will eventually settle. Occasionally bleeding may occur into the eye socket causing visual loss but this is very rare.

Infection Infection in the eye socket is a rare complication which may threaten the vision and which needs prompt attention and treatment with antibiotics.

Double vision The tendency to get double vision after surgery is usually tested for before your operation. Transient double vision may occur as the eye gets used to its new position but may persist if the final position of the operated eye is unsatisfactory. Another operation may be needed if this happens.

Detachment of a muscle Detachment of a muscle is a rare complication that requires further surgery to locate it and reattach it.

Other rare complications include perforation of the eye during surgery with the suture needle. This is usually harmless but may require another operation. Long term inflammation of the eye causing pain is also a rare complication of surgery.

If you have any questions regarding this information, please ask your eye doctor.

 

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