Post-Operative Challenges After Strabismus Surgery: Seeking Solutions

Q: Post-Operative Challenges After Strabismus Surgery: Seeking Solutions

Hello： 1. <br>Ophthalmic Examination： First, you should consult an ophthalmologist as soon as possible, especially the surgeon who performed your previous procedure, to understand your current condition and the specific reasons for your issues. <br>The physician needs to assess y

Postoperative care after strabismus surgery?

About three years ago, I underwent surgery.
For the first year or two, I felt great and my eyes were very strong.
However, now I feel that the muscles are becoming increasingly weak, and my double vision is getting worse, especially when looking to the sides.
Initially, only my right eye was operated on because it was the one that deviated the most.
Before the surgery, the angle of deviation was about thirty degrees, and post-surgery it improved to about ten degrees.
I still cannot see far to the side with my right eye, and when looking to the left, it doesn't feel like it's in the best position.
My vision in the upper left corner is also restricted, preventing me from seeing far to the side.
When my eyes were stronger, I didn't experience much double vision, but now it has become increasingly severe.
I often feel a sense of weakness in my eyes when I'm out, and I find myself constantly trying to control my eye movements.
This feels very unnatural and significantly affects my mood, social interactions, and self-confidence.
Sometimes at night, I find myself thinking about it and crying, feeling very sad.
I am considering undergoing another surgery.
Would it be better to seek the same doctor again?

K, 20~29 year old female. Ask Date: 2023/10/07

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
Ophthalmic Examination: First, you should consult an ophthalmologist as soon as possible, especially the surgeon who performed your previous procedure, to understand your current condition and the specific reasons for your issues.
The physician needs to assess your visual status to determine the underlying cause of the problem.
2.
Discuss Surgical Options: Talk with your ophthalmologist about your options and potential surgical procedures.
They can evaluate whether further surgery is necessary or if there are other treatment alternatives to consider.
3.
Find a Suitable Physician: If you decide to proceed with additional surgery, ensure you find an experienced and qualified ophthalmologist, particularly one with relevant experience related to your condition.
You may want to consult your previous surgeon, as they are more familiar with your case and can provide better postoperative assessments.
4.
Discuss Risks and Expectations in Detail: Before deciding to undergo surgery, carefully discuss the risks, the surgical process, and possible outcomes to ensure you have a thorough understanding of the expectations and risks associated with the procedure.

Reply Date: 2023/10/07

More Info

Post-operative challenges after strabismus surgery can be quite complex and multifaceted. It’s understandable that you are experiencing frustration and emotional distress due to the changes in your vision and eye muscle strength. Strabismus surgery aims to correct the alignment of the eyes, but outcomes can vary over time, and some patients may experience a recurrence of symptoms or new issues as you have described.

Firstly, it is essential to recognize that the effectiveness of strabismus surgery can diminish over time due to several factors, including muscle fatigue, changes in the eye's anatomy, or even the development of new muscle imbalances. The fact that you initially had good results for a couple of years but are now experiencing increased diplopia (double vision) and a sense of muscle weakness suggests that there may be a need for further evaluation.

Regarding your specific concerns:
1. Consultation with Your Surgeon: It is advisable to return to the surgeon who performed your initial procedure. They will have a comprehensive understanding of your case and the surgical techniques used. They can assess whether the muscle adjustments made during the first surgery are still effective or if there are new factors contributing to your symptoms. If you feel comfortable, you can also seek a second opinion from another ophthalmologist specializing in strabismus to explore all available options.

2. Assessment of Muscle Function: A thorough examination of your eye muscles, including their strength and coordination, will be necessary. This may involve various tests to determine how well your eyes work together and whether there are any new imbalances that have developed since your last surgery.

3. Potential for Additional Surgery: If the evaluation indicates that your eye alignment can be improved with another surgical intervention, your surgeon will discuss the potential benefits and risks. It’s important to have realistic expectations about the outcomes of a second surgery, as results can vary based on individual circumstances.

4. Non-Surgical Options: In some cases, non-surgical treatments such as vision therapy may help improve muscle coordination and reduce symptoms of diplopia. This could be a beneficial avenue to explore alongside or prior to considering another surgical procedure.

5. Emotional and Psychological Support: The emotional toll of dealing with vision issues can be significant. It may be helpful to talk to a mental health professional who can provide support and coping strategies as you navigate these challenges. Engaging with support groups or communities of individuals who have undergone similar experiences can also be beneficial.

6. Lifestyle Adjustments: While waiting for further evaluation or treatment, consider making adjustments to your daily activities that may help alleviate some of the stress on your eyes. This could include taking regular breaks during tasks that require intense focus, using proper lighting, and practicing relaxation techniques to reduce eye strain.

In conclusion, your feelings of frustration and sadness are valid, and it’s important to address both the physical and emotional aspects of your condition. Seeking a thorough evaluation from your original surgeon or a specialist in strabismus will be crucial in determining the best course of action moving forward. Remember that you are not alone in this journey, and there are resources and support available to help you cope with the challenges you are facing.

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