I have had intermittent (part of the time) exotropic (eye turning outward) strabismus since the age of two, and am now age fifty. I recently underwent surgery at the Callahan Eye Foundation Hospital in Birmingham, Alabama, with Dr. Martin Cogen. All patients must work closely with their physician to determine the best treatment options for themselves and their condition. However, this is my experience with surgical correction of strabismus.
My strabismus affected both eyes, with the left turning outward more often than the right. I could hold them straight with concentration, but when I was tired, usually in the evenings, my eye tended to drift out to the side at what the doctor called a sixty-degree turn. I have worn glasses with prisms for the last twenty years, and found that they helped to prevent the headaches and eyestrain that trying to hold my eyes straight had caused. However, as is common in people who use prisms in their glasses, as time passed I needed more and more prism. My ophthalmologist suggested I go to Callahan Eye Foundation in Birmingham to see if my eyes could be surgically corrected.
I saw Dr. Cogen for an initial consultation and he did a thorough eye exam. He felt I would be a good candidate for the correction surgery and explained to me that I would have the surgery as an outpatient and, if all went well, could go home the same day. He also explained the risks of the surgery and that in 25% of cases, a second surgery is required in order to properly align the eyes. However, three out of four patients have sufficient correction the first time. I decided to take that risk, as the odds sounded good to me. He assured me they would not have to cut anywhere on my face, and would not cut into my eye, but would be cutting and moving the muscles on the outside of my eye. I also have glaucoma and was told this would not interfere with that.
The reasons I chose to have the surgery were varied. Of course, most people think of strabismus as a primarily cosmetic problem. However, when I was able to hold my eyes straight, I had good vision using both eyes together, so easier use of my vision was a consideration. Also, I had developed some social anxiety over my lifetime because of the fear that others would notice the strabismus. I avoided face-to-face conversations and looking in people’s eyes as I talked to them. Therefore, I also considered surgery an advantage to me socially.
I was told to be at the hospital at 6:30 AM, and we arrived and parked in their parking garage. (Be sure to have your parking ticket validated and don’t expect free parking even though you’re having surgery. Without validation the charge is $15; with validation we still paid $4). We were directed to the outpatient surgical area upon arrival. I dressed in the hospital gown provided and an IV was inserted. The hospital staff was very kind and caring.
I was originally told that surgery is done based on age, with the youngest patients going first, so I expected at age fifty to be the last on the list. However, I was taken to surgery around 11 AM. I was given a shot and went to sleep. I don’t remember anything until I woke up a little later back in the outpatient room where my husband was waiting. A large thick bandage covered my eye and I was having some discomfort. The nurse brought me a pain medication and it helped. About an hour later, after I was able to drink and have some crackers, I was allowed to go home.
I was given an antibiotic cream and some medication for pain, and I was instructed to leave the bandage in place until the next day. The pain that night was moderate and controlled by the medication. I was excited, however, to take off the bandage and see the results of the surgery.
The next day when I removed the bandage, my white part of my eye was very red, but my eyes were aligned. I did not have any double vision. The movement of my eye felt “tight” and I found myself moving my head sometimes to avoid turning my eyes too far in or out. Dr. Cogen called me to see how I was doing. I told him my eyes seemed very straight when they were open, but when I closed them, they felt “all over the place”. He assured me that was normal. I began to put the antibiotic cream in my eye after removing the bandage.
The next morning I woke to a very swollen eye. It was also swollen underneath the eye. I called the doctor’s office and was told I was likely having an allergic reaction to the pain medication and to discontinue its use. (When I saw the doctor for my follow up visit, he said some other ointment should have been called in to my drug store, rather than using nothing, because it helps the stitches fall out.) I stopped using it, and within a couple of days the swelling went down and the eye felt much more comfortable.
After two weeks, I again saw Dr. Cogen in his office. He determined that I still had a very slight turn outward at times (not often), about four degrees versus the sixty I started with, but he felt that might even improve over time. He assured me that we didn’t know the final results of the surgery until the eye completely healed, so not to be anxious about it. I told him I was very pleased already that my eyes looked so straight. He gave me another ointment to use since I had been allergic to the first one.
I was self-conscious about the redness in my eye, and at first I wore sunglasses if I had to go out. At two weeks, the redness was still evident to anyone who looked, but was improving. Three weeks after surgery, the white of my eye was only red at the corners. It gradually improved.
The pain and discomfort of the surgery was controlled by the medication. I am more confident around other people now, and I have much less eyestrain. My advice if you are considering the surgery is to talk with your doctor and ask questions. Overall, I am very pleased I had the surgery.
