Considering Strabismus Surgery in Nepal? Here's What to Ask Your Doctor

Why do I need strabismus surgery in Nepal?

Management depends on the type, cause, age, visual development and measurements. Options may include glasses, amblyopia treatment, prisms, exercises for selected conditions or surgery. Vision Concern can provide an initial eye assessment and referral guidance; a strabismus specialist determines whether surgery is appropriate.

What are the steps involved in strabismus surgery in Nepal?

Ask your doctor to talk about the surgery to be performed, its method, the anesthesia used, the expected duration, and whether it is an inpatient or outpatient procedure. The steps involved in strabismus surgery include correcting misaligned eyes and first of all, the doctors apply anesthesia (a cautious sedation) before the operation. The second step involves making a small incision in the conjunctiva. It is a thin, transparent tissue covering the white part of the eye (sclera). The surgeon then identifies whether the eye muscles need to be operated on or not. If the muscle is tight, a retraction procedure is done to detach the muscle from the eyes and reattach it again. This allows the free movement of the eyes and solves issues of strabismus. In cases where the muscle is too weak, a resection procedure is used to shorten the muscle and remove the section that causes the muscle to pull. Once the muscle correction process is done, the surgeon sews the eye muscle to the sclera. This fine post-operative adjustment is known as suturing. At the end of the strabismus surgery, the conjunctiva is closed with dissolvable sutures. By understanding such a question, we can have a better understanding of the surgery that is scheduled for our strabismus.

Inquire about potential risks and side effects of strabismus surgery

There are several questions you can ask your doctor when you are conscious of the potential risks and side effects of strabismus surgery in Nepal.

• What are the common risks associated with strabismus surgery in Nepal?
• Is there a possibility of partial or complete failure for double vision?
• Are there potential complications relating to visuals and the repositioning of extraocular muscles?
• What postoperative care measures can be taken to prevent adverse consequences?

Postoperative medicines and activity restrictions must be prescribed by the operating surgeon. Do not start antibiotics, steroid drops or combination medicines such as TobraDex without individual medical instructions.

What are the follow-up care and activity restrictions after strabismus surgery?

The follow-up care includes ice or cold packs to reduce the swelling. Visit the doctor for follow-up appointments with an eye doctor. Also, notice any signs of danger, like swelling/pain, fever, bleeding, or sudden changes in eye alignment, if any. Immediately after the strabismus surgery, it's advisable not to be involved widely in heavy outdoor games or activities. Also, avoid swimming for at least 2 weeks if you are fond of it. It's strictly restricted to rubbing your eyes, as eyes can easily infect and cause irritation in such a scenario. Avoid hair washing to avoid soap and shampoo getting in the eyes. There are cautious steps you can take to prevent complications and monitor eye issues, if any.

Are there overcorrection or undercorrection chances in strabismus surgery?

There is a risk of both overcorrection and undercorrection associated with strabismus surgery in Nepal. This complexity of the eyes is not completely controlled, but major recovery is seen. Some of the risk involves statistical variation (issues in the statistical bell-shaped curvature of the eyes), and binocular vision risks can also be seen. In younger children, strabismus surgery remains controversial, as exotropia might not be taken into account for long-term alignment of the eyes. Patients should have realistic expectations, as there are risks of optimal alignment of around 10%. Vision therapy is recommended to improve eye coordination, correct visual alignment, and strengthen eye muscles after strabismus surgery. In some cases, additional surgery may be required to restore proper eye alignment.

Differences between Under and Overcorrection of strabismus Surgery

What are the symptoms of under-correction in strabismus surgery?

Under-correction in strabismus is a situation in which the eye alignment is not fully corrected. This can arise in surgery because of pre-operative measurement errors, intra-operative measurement errors, and excessive inflammation. The common signs and symptoms associated with under-correction in strabismus correction procedures include,

1. Residual eye misalignment

The eye turns inward, outward, upward, or downward, in this residual eye misalignment. This denotes that the surgery is not fully done.

2. Double vision

Patients experience that the vision is hazy, double, or ghosting. This is why the eyes with under correction can face issues in having a proper focus on distant objects.

3. Eye strain or fatigue

Eye strain is also seen in the under-correction of strabismus surgery. One faces fatigue from focusing on objects at near or far distances.

4. Limited binocular vision

Binocular vision denotes the ability of one's person to see an object clearly when both eyes are focused on it. When both faces synchronize because of corrective eye surgery, clear depth perception and overall visual function may be impacted.

5. Cosmetic concerns

In under-correction, the eyes are not aligned properly, which denotes how an asymmetrical look is more concerned with the appearance of the eyes.

What are the treatment options for under-correction in strabismus surgery?

Once under-correction is noticed in strabismus surgery, you can consult your doctor and ask him about the treatment option. The treatment options include,

1. Prism adaptation

Prism adaptation places a temporary Fresnel prism on the patient's glasses to correct the full deviation of vision resulting from under-correction.

2. Adjustable Sutures

Adjustable sutures evaluate the strabismus surgery to improve the postoperative outcome. The adjustments can be made within a few hours or even after a delay of several hours to a few days. This is fine-tuning for eye alignment and corrections.

3. Consulting and follow-up

Patients can consult with an eye surgeon who specializes in strabismus surgery to conduct any alterations needed to treat the under-correction of the eyes. Vision Concern's supportive staffs and eye care expert, helps you correct your vision with required surgery procedure in Nepal.

Conclusion

Vision Concern provides eye assessment, optical support and referral guidance. Strabismus surgery must be assessed and performed by an appropriately qualified ophthalmic surgeon.

Authoritative Strabismus-Surgery Reference

For clinical background on adult strabismus surgery, see the American Academy of Ophthalmology clinical statement. Diagnosis, non-surgical options, surgical suitability and informed consent must be handled by an ophthalmologist or strabismus specialist.