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Strabismus Surgery in Children: What to Expect

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Children’s vision can be affected by a wide range of issues from common myopia “nearsightedness” to amblyopia or “lazy eye” to strabismus “cross-eyed.” Strabismus in children is defined as improper alignment of the eyes, either horizontally, vertically or torsionally (twisted), and is caused by muscles not working in synch. For the one in 50 children affected by strabismus, surgery is often the best option to ensure successful development and optimal vision later in life.  

Dr. Jeffrey Leen, a leading Rockland County, NY pediatric ophthalmologist at Rockland Eye Physicians & Surgeons who has performed successful strabismus surgery on thousands of children, believes the key to strabismus treatment is early detection and correction. Strabismus can be present in infancy or can develop in early childhood and the sooner it’s corrected, the better. Left untreated, strabismus can cause long-term visual impairment. “There is a relatively short therapeutic window for eye correction in children,” according to Dr. Leen. “Before the age of nine, a child’s visual system is still in the developmental phase. Correction after age nine can be very difficult.” For children diagnosed early, the prognosis for complete recovery from strabismus surgery is excellent. Children are able to recover relatively quickly and their developing brains are flexible enough to accept the surgical muscle changes smoothly.

Rockland County strabismus surgeon Dr. Leen and his associates are experienced in and compassionate about the unique challenges of pediatric patients. “Working in pediatric ophthalmology and with strabismus cases in particular, I must pay careful attention not only to the needs of the patient, but to the concerns of their parents as well.” understands Dr. Leen, a father himself. While young children are typically not aware of the details of strabismus surgery, Dr. Leen takes great care in educating parents and allaying their fears.

What you can expect from strabismus surgery with Rockland Eye:

Pre-Operative Preparation

Your child will see Dr. Leen for a series of in-office examinations prior to surgery. The appointments will be scheduled for different times and different days allowing Dr. Leen to take into account fluctuations in eye movements occurring from varying levels of fatigue. In addition, since children are not always attentive during exams, multiple measurements increase the likelihood of catching them in a cooperative mood, thereby improving the quality of the data collected. This meticulous pre-operative planning is critical to the success of strabismus surgery in children.

The Day of Surgery

Dr. Leen conducts his pediatric strabismus surgeries at New York’s Nyack Hospital. The nurses and anesthesiologists at Nyack Hospital perform a high volume of pediatric surgeries and are very experienced in caring for the unique needs of children. The entire surgery, from start to finish, is done by Dr. Leen. The same-day surgery is typically performed on a Friday and is scheduled for early in the morning to minimize the time that children must fast. General anesthesia is used so your child will not experience any pain or anxiety during surgery. The procedure typically takes only 45-90 minutes and after recovering for a few hours your child can return home by early afternoon.  

Post-Operative Recovery

Strabismus surgery recovery time is usually brief. Children recover from surgery very well due to the resilience of their young bodies. The first 24-36 hours will require rest and pain can be treated simply with children’s acetaminophen. Dissolvable stitches are used during surgery, eliminating the need for a follow up procedure to remove them. For a period of time your child will require eye drops, but eye patches are seldom needed. Eighty percent of the healing occurs within the first 1-2 weeks, so children can resume their normal activities very quickly. Some children are able to return to school within a matter of days, while others families choose to keep children home for a week of rest. Either way, your child will soon be able to return to sports and other social activities.

It is important to note that a child’s need for glasses to correct vision impairment is not affected by strabismus surgery. The surgery corrects the muscles controlling the direction of the eyes, improving depth perception and correcting diplopia or “double vision,” as well as resolving the cosmetic factors of being cross-eyed. It does not correct near or far sightedness.

While strabismus surgery is fairly common and its management is straightforward in children, it is still a complex surgery. Each strabismus case presents unique challenges for the surgeon. One patient’s strabismus may be more or less severe depending on the direction they look or may affect their near and far vision differently. As such, choosing an experienced strabismus surgeon with extensive pediatric experience is critical to reducing the possible side effects of over- or under-correction as much as possible. As a leading New York strabismus surgeon, Dr. Leen’s success rate places him among the best in the field.

Stabismus surgery may also be needed in adulthood and adult strabismus patients present their own unique challenges. Some may have had surgery as a child, others may have lived with strabismus for years but their ability to compensate for the vision flaw is weakened as they age; others may simply be seeking cosmetic improvement. Additionally, some elderly patients develop strabismus as the result of a stroke or nerve palsy. For adults, strabismus surgery is more challenging in that recuperation time is increased and post-operative discomfort is typically greater than in children.  Unlike children, adults will often require narcotic analgesics for pain suppression and may experience discomfort for up to a full week. Further, their vision issues may take longer to improve as their brains are less flexible and accepting of changes.

To learn more about strabismus correction surgery and Rockland Eye Physicians & Surgeons we invite you to call today for a consultation appointment. We look forward to getting to know you and your child and helping pave the way for your child’s successful development and growth.