Monocular Strabismus: Post-Surgery Vision Concerns

Q: Monocular Strabismus: Post-Surgery Vision Concerns

Hello Olivia： If you can't see much difference when wearing them, then the result is the same as not wearing them. <br>If there is a tendency for misalignment, it will still occur regardless of wearing a monocular lens. <br>However, since you have already undergone strabismus sur

Monocular strabismus

Hello doctor, I have had strabismus and amblyopia in one eye since childhood, with visual acuity of 0.2 in one eye and 0.9 in the other.
I am nearsighted with a prescription of -2.50 diopters, and I only wear contact lenses in one eye (since I can't see well with the eye that has 0.2 vision).
However, when taking photos or wearing a contact lens in just one eye, the strabismus becomes more noticeable.
Recently, I underwent surgery to adjust the eye position for my strabismus.
I would like to ask, one month post-surgery, if I continue to wear contact lenses in only one eye, will the strabismus in the other eye still be noticeable? (I read online that wearing a contact lens in one eye can still cause the other eye to drift.) Thank you!

Olivia, 30~39 year old female. Ask Date: 2020/12/18

Dr. Gao Pilin reply Ophthalmology

Hello Olivia: If you can't see much difference when wearing them, then the result is the same as not wearing them.
If there is a tendency for misalignment, it will still occur regardless of wearing a monocular lens.
However, since you have already undergone strabismus surgery, which aims to correct the eye position surgically, the adjusted muscles post-surgery will limit the force of eye misalignment, and it should not deviate in the short term.
The Ophthalmology Department at Puzi Hospital in Taiwan is open on Monday, Tuesday, Thursday, and Friday from 8:00 AM to 12:00 PM, and on Wednesday from 2:00 PM to 4:30 PM.
Online responses can only serve as a reference; it is necessary to seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.
Gao Pilin

Reply Date: 2020/12/18

More Info

Hello! Thank you for your question regarding monocular strabismus and the concerns you have after your recent surgery. It’s understandable to have questions about your vision, especially after undergoing a procedure aimed at correcting strabismus.

To begin with, it’s important to clarify that strabismus, or misalignment of the eyes, can be influenced by various factors, including the visual acuity of each eye. In your case, you mentioned having a significant difference in visual acuity between your two eyes (0.2 in one eye and 0.9 in the other). This disparity can affect how your brain processes visual information from each eye, potentially leading to continued misalignment, especially if one eye is favored over the other.

After strabismus surgery, the goal is to improve the alignment of the eyes and enhance binocular vision. However, the effectiveness of the surgery can be influenced by several factors, including the pre-existing conditions of your eyes, the degree of misalignment, and how well your brain adapts to the changes post-surgery.
Regarding your specific question about wearing a contact lens in only one eye after surgery: Wearing a contact lens in the eye with better vision (0.9) while having the other eye (0.2) uncorrected can indeed lead to continued strabismus in the weaker eye. This is because the brain may still favor the stronger eye, leading to a lack of coordination between the two eyes. The eye with lower vision may not receive the same level of visual input, which can perpetuate the misalignment.

In the context of your recovery, it’s crucial to follow your surgeon's post-operative instructions. If you are still experiencing misalignment after one month, it may be beneficial to consult with your ophthalmologist or a strabismus specialist. They can assess your eye alignment and visual function to determine if additional interventions, such as vision therapy or further surgical adjustments, are necessary.

Additionally, engaging in vision therapy might be helpful. This type of therapy can assist in improving the coordination between your eyes and enhancing the visual processing capabilities of your brain. It often involves exercises that promote the use of both eyes together, which can be particularly beneficial in cases of strabismus and amblyopia (lazy eye).

In summary, while wearing a contact lens in only one eye post-surgery can contribute to continued misalignment, it’s essential to have a comprehensive evaluation by your eye care provider. They can provide personalized recommendations based on your specific situation and help you understand the best course of action to improve your visual alignment and overall eye health.
Remember, recovery from strabismus surgery can take time, and it’s important to be patient with the process. Regular follow-ups with your eye care professional will be key in monitoring your progress and making any necessary adjustments to your treatment plan. Thank you for reaching out, and I wish you the best in your recovery journey!

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