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Medical Forum / General / Vision / February 2006

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Adult strabismus surgery

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strab_q@yahoo.com - 14 Feb 2006 04:02 GMT
Hi all,

I had surgery just over two weeks ago, on just one eye. I'm male, early
40s, had it since I was maybe 9 years old. The doctor was very
confident of at least a cosmetic fix, which was my primary concern.  He
was highly recommnded to me by TWO eye doctors. I had double vision the
first few days, so obviously the correction was made. That cleared
up... and at 5 days post-op the doc said my eyes were "cosmetically
straight". That was very hard for me to tell because the red was so
distracting.

My next follow up is in another week, which will be almost one-month
post op.

I am very confused and upset. As anyone who has lived with this knows,
the offer of a cosmetic fox is HUGE to us. My hopes were set quite
high. Well I dont understand what has happened because now it looks to
me be 70 or 80% back where it was. Maybe I am just tired but I dont
know, does it vary much from day to day based on fatigue? In any case
it doesnt seem to be anywhere near fixed and this is quite a hope to be
dashed.

I dont understand why the surgery sometimes doesnt work. Is there any
hope that it will be anywhere near OK with a few more weeks of healing?
Does this result tell me anything about the chances of a second surgery
being succesful?

I'm sure my doctor will have some answers in a week, but from now until
then I am desparate to find some hope in all this.
strab_q@yahoo.com - 14 Feb 2006 04:14 GMT
I should add...

Numerous people have said that cosmetically it IS much better, if not
perfect. But it doesnt look that way to me when I take a photo in the
mirror.

I am not expecting perfection. All I am wanting is to go from my pre-op
state, in which the deviation was noticeably distracting to others...
to a state where it is no longer distracting. Maybe this is a
pyschological thing? That I am so self-concious of it that I cannot see
sufficient improvement where others can?

I am really wildly all over the map when I analyze it. Sometimes I look
at a photo and think, hmmm thats not exactly right but its sufficiently
better that it has solved the problem. Other times, like if I
unscientifically gauge how close it is, I end up depressed thinking it
hasnt improved much at all.

Has anyone else been through this? Or counseled patients on this? This
is driving me crazy. All I wanted was my self-esteem back.
Jane - 15 Feb 2006 03:12 GMT
I understand your anxiety and concern about your surgery results.  I
had strabismus surgery a couple of years ago on one eye to correct
esotropia and double vision, which I had developed as an adult.  Before
the surgery, I was told that there was about a 75 percent chance that
the operation would be successful and a 25 percent chance that it would
not be.  The explanation I was given was something like this:  The eye
muscles can be surgically tightened/loosened to properly align the
eyes.  However, the brain acts as the softwear that directs the eye
muscles, and a defect in the program might cause the eyes to misalign
again.  In addition, eye muscle surgery is not an exact science, and
there is lots of difference in terms of how people might respond to,
say, a 6 mm muscle recession.  I was also told that eye muscle surgery
can be repeated.  I think that vision therapy can also be effective in
treating some cases of strabismus.  Psychotherapy can help self-esteem
problems.  There is a strabismus support group on Yahoo that you might
check out.  Best of luck to you!
CatmanX - 16 Feb 2006 20:41 GMT
Why do people expect miracles immediately?

Your doctor can do nothing until all the inflammation has settled. Just
relax, stop worrying about how your eyes look and wait until your next
visit.

In strab surgery, there are no guarantees on even simple cases as there
are variables that the surgeon can't know of until the surgery has been
performed. At your next follow-up, he can get more insight into what is
happening.

dr grant
Neil Brooks - 16 Feb 2006 21:13 GMT
>Why do people expect miracles immediately?
>
>Your doctor can do nothing until all the inflammation has settled. Just
>relax, stop worrying about how your eyes look and wait until your next
>visit.

That's why I developed the delayed adjustable suture technique.

Before my third strab surgery (1998), my surgeon explained the
inflammation to me.  I asked him, "Then why don't we just wait a
couple of days before adjusting the sutures."

Et voila ... a new method was developed ... for which I receive
exactly zero money :-(  

He takes the credit ... and I let him ... because he's genuinely a
good guy and a great ophthalmologist :-)

But he and I /both/ know....

Agree w/Dr. Grant: be patient until it's time not to.  It's not time
yet.
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