Squint surgery

What is a squint?

A squint is when one eye appears straight and the other turns in, out, up or down. To make this better, some people choose to have an operation. This is done under general anaesthetic which means you are asleep for this operation.

How is the surgery done?

There are 6 muscles which help the eye to move. In squint surgery one or more of these muscles are strengthened or weakened to help how the eyes align. This is done by moving the positions of the muscles on the eyeball. The muscles are stitched in their new positions with dissolvable stitches. The eye ball remains in the eye socket during the surgery.

Before the day of surgery

Approximately 1 week before surgery your child will have an appointment where we measure the size of the squint to ensure the eyes are in a stable position before the operation. You will also meet with the doctor to answer any questions that you may have.

What will happen on the day of surgery?

Before surgery your child will have to stop eating and drinking for around 8 hours. We will tell you in advance what time to stop eating and drinking by.

On the day of the operation you we will show you to your bed or chair in the Theatre Assessment Unit (TAU). Children can wear their own pyjamas and bring a teddy if they wish.

You child has an anaesthetic in the anaesthetic room, where parents and carers are able to stay with their child. Once your child is asleep you can wait nearby and the staff will let you know when you are able to come back to your child.

How long will the operation take?

Squint surgery usually takes around 1 to 2 hours.

What will it feel like afterwards?

The eyes will be uncomfortable, sore and gritty. You can give regular pain relief available from your local pharmacy.

The white part of the eye will be red, this is a kind of bruise, and this will improve over a few weeks.

There may be blood in the tears, this is normal after squint surgery.

What happens when I go home?

We will give you antibiotic and steroid drops to use 4 times a day for 4 weeks after your operation to prevent infection and help recovery.

If children wear glasses they will need to continue wearing the glasses after the surgery.

What are the risks of squint surgery?

Squint surgery is generally a safe procedure but as with any operation there is a risk of complications.

• Redness in the eye – this can take several weeks to go away
• Scarring – most of the scaring on the white part of the eye is not noticeable after 3 months
• Under or over correction – the outcome of squint surgery is not always predictable, and it is possible that the original squint is still present or the direction may change. In some cases, more than one operation is needed.
• Double vision – children may have double vision as their brain adjusts to the new eye position. This is common and often settles within a few days. Rarely, double vision can continue and further treatment with prisms or more surgery may be needed.
• Pupil changes – rarely the pupil can be a larger on the eye which has had surgery.
• Allergy – some people have a mild allergic reaction to the drops used after surgery leading to irritation of the eye lids. This resolves once the drops have been stopped.
• Stitches – an infection can occur around the stitches. Following advice and using the eye drops after surgery reduce the risk of this.

Rare complications

• Lost or slipped muscle – this can happen if the stiches do not hold the muscle in the correct position. When this happens the eye position suddenly changes and the eye cannot move in a certain direction. This is a rare complication and happens in 1 in 400 people. Should this happen further surgery is needed.
• Perforation of the eye – this is a rare but serious complication of squint surgery which can lead to retinal detachment and loss of vision. It can be treated with laser if noticed during surgery.
• Severe infection in the eye – this kind of severe infection could permanently damage vision in the eyes, but the risk is very low and is 1 in 20,000 people.
• Anaesthetic risks – anaesthetics are usually safe but there are small but potentially serious risks. An unpredictable reaction occurs in 1 in 20,000 patients and death in one in 100,000.

For more information about the date of the operation please contact the waiting list coordinators on 0114 305 3559.