home Adviсe The squint of the eyes went away again after the operation. Recovery after strabismus surgery. High-tech strabismus surgery

The squint of the eyes went away again after the operation. Recovery after strabismus surgery. High-tech strabismus surgery

Often, strabismus surgery does not immediately return normal vision. Many will agree that it is a pity to look at a young, pretty girl or child looking askance. Without this cosmetic defect everything would be fine. In addition, ophthalmologists recommend trying conservative methods of treating strabismus before going under the knife.

What is strabismus, or strabismus?

Strabismus is a pathology in which one, both, or alternately the right and left eyes deviate from the normal position when looking straight. When a person looks at an object, the information received by each eye is slightly different, but the visual analyzer in the cortical part of the brain brings everything together. With strabismus, the pictures are very different, so the brain ignores the frame from the squinting eye. The long-term existence of strabismus leads to amblyopia - a reversible functional decrease in vision, when one eye is practically (or completely) not involved in the visual process.

Strabismus can be congenital or acquired. Newborns often have a floating or sideways gaze, especially after a difficult birth. Treatment by a neurologist can remove or alleviate the manifestations of birth trauma. Another cause may be a developmental abnormality or improper attachment of the extraocular muscles (see Fig. 1).

Acquired strabismus occurs as a result of:

infectious disease: influenza, measles, scarlet fever, diphtheria, etc.;

somatic diseases;

injuries;

a sharp drop in vision in one eye;

myopia, farsightedness, high and moderate astigmatism;

stress or severe fear;

paresis or paralysis;

diseases of the central nervous system.

How can you get rid of strabismus?

Strabismus corrects:

wearing special glasses;

a series of eye exercises;

wearing a blindfold covering one eye;

surgery to correct strabismus.

Variable strabismus, when sometimes the right or left eye squints, is tried to be corrected by wearing a bandage. Long-term use of specially designed glasses often helps. Exercises to strengthen the ability to focus are recommended for almost all patients with strabismus. If all of the above methods do not correct vision, surgery is performed to correct strabismus. This type of surgery is performed both in infancy and in adulthood.

Types of surgeries to correct strabismus

The following types of strabismus occur in children and adults:

horizontal - converging and diverging relative to the bridge of the nose;
vertical;
combination of two types.

Doctors encounter convergent strabismus more often than divergent strabismus. Along with converging strabismus, the patient may have farsightedness. Myopic people usually have divergent strabismus.

During the operation the following can be performed:

amplification type surgery;
debilitating surgery.

In weakening surgery, the eye muscles are transplanted a little further from the cornea, which tilts the eyeball in the opposite direction.

During augmentation surgery, a small piece of the eye muscle is removed, causing it to shorten. This muscle is then sutured to the same place. Surgery to correct strabismus involves shortening and weakening the target muscles, which restores balance to the eyeball. The operation is performed on one or both eyes. The microsurgeon determines the type of surgical intervention when the patient is in a completely relaxed state on the operating table.

In some clinics, the operation is performed under local anesthesia only for adults. and in others, all patients are given general anesthesia. Depending on age, health status and other factors, mask (laryngeal), endotracheal anesthesia using muscle relaxants, or an alternative type of anesthesia is performed.

It is important that during surgery the eyeball is motionless and there is no tone in the muscles, because the surgeon conducts a special test: he evaluates the degree of restriction of eye movements by moving it in different directions.

After surgery, an adult can go home on the same day. The child needs preliminary hospitalization. Most often, mothers are in the hospital with their children; discharge occurs the next day after the operation. The recovery period takes about 14 days. After discharge, the patient extends the sick leave or certificate at his clinic.

It should be noted that in 10-15% of cases, strabismus is not completely eliminated and repeated surgery may be necessary. Surgery using adjustable sutures helps reduce the failure rate. After the patient wakes up, the doctor checks the condition of the eyes after some time under local anesthesia. If there are deviations, he slightly tightens the suture knots and only then finally secures them. All types of operations are performed with completely absorbable suture material.

Adults who have lived for a significant period of time with strabismus sometimes experience double vision after surgery because the brain is unaccustomed to perceiving a binocular image. If before the operation the doctor has determined that there is a high probability of developing double vision, the correction of strabismus is done in two stages so that the brain can gradually adapt.

Carrying out the operation

A few days before surgery, you need to take blood tests, do an ECG and undergo a consultation with some specialists. You should not eat 8 hours before surgery. If it is scheduled for the morning, you can have dinner, and if it is in the afternoon, then a light breakfast is allowed. The child and mother are admitted to the hospital a couple of days before the operation. The procedure is performed under general anesthesia. The operation itself lasts 30-40 minutes, then the patient is taken out of anesthesia and transferred to the ward. All this time, a bandage is placed on the eye. After the operated patient has completely recovered from anesthesia, he is examined by a surgeon in the afternoon. He opens the bandage, checks the eye, puts in special drops and closes it again. After this, adults are sent home with detailed recommendations: what medications to take, what to put in their eyes, and when to come for a second examination. The eye patch is left until the next morning. After a week, you need to come for an examination, where the doctor will assess the speed of healing and the condition of the eye. The final assessment of eye position is carried out after 2-3 months.

For several weeks after surgery, special anti-inflammatory drops and (if necessary) antihistamines are used. The eye will be red and swollen. Sometimes the next morning the eye will stick together due to accumulated pus. There is no need to be scared: it is washed with warm boiled water or sterile saline solution. For a couple of days the eyes will be very watery and sore, and it will also seem as if there are specks in the eye. The sutures dissolve on their own after 6 weeks.

For a month after surgery, you need to carefully protect your eye. You cannot swim, be in dusty rooms or play sports. Children at school are exempted from physical education for six months.

A month after the operation you need to undergo a course of treatment. To restore the binocular ability to see and recognize the correct picture, you need to undergo special hardware treatment at a medical center. Some clinics have the Amblicor complex, developed by specialists from the Brain Institute. Treatment using this device is a computer video training. It helps overcome the skill of suppressing vision in one eye. While watching a cartoon or movie, an EEG of the visual cortex of the brain and readings about eye function are continuously taken from the patient. If a person sees with both eyes, the film continues, and if only with one, it pauses. Thus, the brain is trained to perceive the image from both eyes.

Strabismus in children

Detected strabismus in children under one year of age will not heal on its own, the child will not outgrow it, and the pathology will not disappear anywhere. If the disease is present and the symptoms can be identified, treatment cannot be delayed. Otherwise an unused squinting eye loses the ability to see and develops farsightedness or amblyopia– lazy eye syndrome.

When the visual apparatus works in a coordinated manner, the muscles of both eyes work together and focus the gaze on one point in space. In the case of strabismus, the work of the eye muscles is uncoordinated and joint movement of the eyes becomes impossible.

Each eye is directed in its own direction (convergent or divergent strabismus), as a result of which the brain is not able to determine the amount of incoming information and combine two images into one.

Causes

Convergent strabismus in a child can be caused by the following reasons:

congenital (non-permanent) strabismus - may be present from birth or occur in the first months of life. The reasons lie in intrauterine processes; infectious diseases of the mother or the consequences of microscopic hemorrhage;
impaired visual acuity (ametropia), causes: farsightedness, myopia, astigmatism;
a consequence of disturbances in the functioning of the child’s central nervous system, the causes are cerebral palsy, hydrocephalus;
acquired (amblyopia) – past illnesses: diphtheria. measles, flu, rubella;
consequences of fright or severe stress;
injuries, fractures, bruises.

Strabismus, depending on the timing of appearance, causes of occurrence, complexity and degree of manifestation, can be: non-permanent, descending, hidden, friendly, imaginary.

Sometimes parents are terribly frightened by diagnoses of amblyopia. descending or imaginary strabismus in children under one year of age, although such phenomena are temporary and are caused by the immaturity of the visual apparatus, conductive channels and nerve endings.

Symptoms

Convergent strabismus in children of any age is determined by the following signs:

the child is unable to simultaneously direct both eyes to one arbitrarily selected point (convergent, divergent or alternating strabismus);

non-friendly eye movement;

one eye visibly squints or closes in bright light (amblyopia);

the child has an involuntary desire to tilt his head at a certain angle in order to look at an object (hidden strabismus);

impaired perception of spatial depth (the child may fall or bump into objects).

Children of preschool age and older may have Complaints of blurred vision, eye strain, increased photophobia, or objects appearing in two. Symptoms may occur periodically and become worse during periods of increased fatigue or illness.

In newborns and infants, farsightedness, as well as slight intermittent strabismus, are quite common. But since the disease disappears, after 4 - 5 months the eyes become even.

Treatment

Treating unstable convergent and divergent strabismus will be much easier if the process is started in a timely manner. Types of treatment are as follows: conservative (therapy) and surgical (surgery). The therapeutic method includes special exercises and involves complex and lengthy treatment. Strabismus, amblyopia and farsightedness can be successfully treated without surgery.

The main stages of strabismus treatment are:

examination to determine the cause of strabismus;

preliminary correction of visual acuity (glasses or contact lenses);

diploptic and orthoptic hardware treatment (restoration of binocularity);

elimination of amblyopia (amblyopia - lazy eye syndrome);

consolidation of the achieved effect.

Operation

Surgery will be appropriate only if the therapeutic method is completely ineffective. The most favorable period for carrying out such operations is the age of 4 - 5 years. A preschool child is able to adhere to all recommendations and perform the necessary orthoptic exercises.

Congenital paralytic strabismus in children with a large angle of deviation, especially vertical divergent - alternating, therefore surgical treatment of childhood strabismus is carried out at an earlier age.

Surgery to correct strabismus (surgical correction) involves two types of surgical solutions:

weakening of an overstrained extraocular muscle after its intersection or partial excision of the muscle;

strengthening of weakened muscles by excision with their further fixation.

Both methods in their pure form are rarely implemented, since in most cases the symptoms of the disease have to be treated in a combined way.

Depending on the complexity of the painting, the desired effect may not be achieved the first time. In this case, a repeat operation is prescribed, which is performed no earlier than 6 to 8 months later.

At the first stage of surgical treatment, the goal is to remove the cosmetic defect, that is, to cure convergent, divergent, and less often alternating concomitant strabismus, which traumatize the psyche of a child of any age, after which amblyopia, farsightedness and visual function are treated.

Sometimes, after surgical treatment of strabismus in children, an acquired specific complication is observed - hypercorrection. resulting from errors in calculations. The side effect develops not only immediately after the operation, but also a little later. In this case, the operation is repeated.

Gymnastics

To strengthen the eye motor muscles, experts recommend performing certain exercises:

raising your hand up with your index finger extended and, performing a vertical downward movement, lower it, bringing your finger closer to your nose, then repeat the same, but horizontally, moving your hand to the side;

“write” a figure eight with your eyes, make circular movements, then look up and down, left, right.

Games with a ball or shuttlecock will be very useful. Table and lawn tennis, football, volleyball help the child to follow the moving ball with his eyes, which constantly changes direction, approaches and moves away.

It will be useful for preschool and school-age children working at a computer. periodically look out the window, look at distant objects. After this, focusing your gaze on something nearby.

Similar exercises are performed daily for 10–15 repetitions, in the afternoon or after dinner. If you are not lazy and take the issue seriously, the proposed gymnastics will help cure the disease.

The result of strabismus treatment is not only a successful operation, but also perseverance, the desire to recover and, of course, regular daily exercise.

Prevention

There are a number of rules, the observance of which will help correct convergent strabismus in children, as well as preschool children and schoolchildren:

To avoid staring at one point, it is not recommended to hang a child of any age near the crib objects that attract attention. It is optimal if the crib has access from all or at least several sides;

To prevent farsightedness and imaginary strabismus, rattles in the stroller should hang at arm's length baby;

necessary ensure even load on the eyes child, after which the brain will be able to evenly process signals coming from outside;

A child’s acquaintance with television should take place at the age of no earlier than 3 years, with mandatory limiting screen time ;

It is not allowed to watch TV while lying down. To do this, you can put a pillow and take a semi-sitting position;

need to be carefully ensure correct posture. especially at your desk. Children with poor posture have the habit of bending low over the table, which can result in amblyopia and farsightedness;

check and exclude literature with small print from the student’s library;

small pictures and fonts on the monitor unnecessarily overload the eye muscles, so Communication with a computer should begin no earlier than 8 years of age ;

in the presence of a hereditary factor, regular examinations by an ophthalmologist- Necessarily;

if possible protect the child from stress and mental trauma .

If this is not an imaginary strabismus, you cannot let the course of the disease take its course. The sooner you start treating its symptoms and doing special exercises, the better.

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Strabismus

The ultimate goal of strabismus surgery is to restore symmetrical (or as close to symmetrical) eye position as possible. Such operations, depending on the situation, can be performed both in adults and in children.

Types of surgeries to correct strabismus

In general, there are two types of operations for strabismus. The first type of surgery is aimed at weakening the overly tense extraocular muscle. An example of such operations is recession (crossing a muscle at its insertion and moving it in such a way as to weaken its action), partial myotomy (partial excision of part of the muscle fibers), muscle plastic (for the purpose of lengthening). The second type of surgery is aimed at strengthening the action of the weakened extraocular muscle. An example of operations of the second type is resection (excision of a section of weakened muscle near the attachment site with subsequent fixation of the shortened muscle), tenorrhaphy (shortening of the muscle by forming a fold in the muscle tendon area), anteposition (moving the site of muscle fixation in order to enhance its action).

Often, during surgery to correct strabismus, a combination of the above types of surgical intervention (recession + resection) is used. If, after surgery, there is residual strabismus that is not leveled by self-correction, repeated surgery may be required, which is usually performed after 6 to 8 months.

To achieve maximum effectiveness when performing surgery to correct strabismus, you must adhere to several basic principles.

1. Unnecessarily speeding up the process of surgical correction of strabismus often leads to unsatisfactory results. Therefore, all manipulations should be carried out in doses (if necessary, in several stages).

2. If it is necessary to weaken or strengthen individual muscles, dosed surgical intervention should be distributed evenly.

3. When performing surgery on a specific muscle, it is necessary to maintain its connection with the eyeball.

High-tech strabismus surgery:

Specialists from children's eye clinics have developed modern high-tech radio wave surgery using the principles of mathematical modeling.

Advantages of high-tech eye surgery:

The operations are low-traumatic; thanks to the use of radio waves, the structures of the eye are preserved.
After the operations there is no terrible swelling, the patient is discharged from the hospital the next day.
Operations are precise.
Thanks to the principles of mathematical calculation, we can ensure the highest accuracy and show the guaranteed result of the operation even before it is carried out.
The rehabilitation period is reduced by 5-6 times.

Result of the operation: highly effective strabismus surgery technologies make it possible to ensure a symmetrical gaze position for various types of strabismus, including those with small and unstable angles, and to restore the mobility of the eyeball in paralytic strabismus in 98% of cases. This is a unique way to effectively help the patient.

Results of surgery for strabismus

Surgical treatment of strabismus allows you to correct a cosmetic defect, which is a strong traumatic factor for patients of any age. However, to restore visual functions (i.e., binocular vision) after surgery, an integrated approach is required, which includes pleoptic therapy (it is aimed at treating amblyopia accompanying strabismus) and orthoptodiploptic therapy (restoration of depth vision and binocular functions).

A one-stage operation to correct strabismus in adults can be performed on an outpatient basis; when treating children, hospitalization is necessary in most cases. The approximate recovery time after surgery is 1 week, but to recreate full binocular vision, i.e. The ability to see a three-dimensional image with both eyes at the same time is not enough. During the time that a person had strabismus, the brain, figuratively speaking, “forgot how” to combine images from both eyes into a single image, and it will take quite a long time and significant effort to “teach” the brain this again.

It should be mentioned that, like any operation, surgical correction of strabismus may be accompanied by the development of certain complications. One of the most common complications of strabismus surgery is excessive correction (so-called hypercorrection), caused by errors in calculations. Overcorrection may occur immediately after surgery, or may develop after some time. For example, if the operation was performed in childhood, then in adolescence, when the eye grows, the child may experience strabismus again. This complication is not irreparable and can be easily corrected with surgery.

This surgical intervention is performed in most ophthalmological centers in Moscow and Russia (both commercial and public). When choosing a clinic for an operation to correct strabismus, it is important to study the clinic’s capabilities, living conditions, whether the clinic is equipped with modern equipment and other important points. It is equally important to choose the right doctor to perform the operation. After all, the prognosis of treatment will fully depend on his professionalism.

If you or your relatives have already undergone surgery to correct strabismus, we will be grateful if you leave feedback about the intervention and the clinic where the procedure was performed, as well as the results obtained

Strabismus in children (diagnosis, treatment methods)

Strabismus(eye deviation) is one of the main problems in pediatric ophthalmology. At birth, the connection between the eyes of the child has not yet been formed and therefore for some time (usually up to 6 months) intermittent strabismus may occur. However, after 6 months, when the joint work of the eyeballs begins to form and binocular vision appears, the position of the eyes should be correct and stable. If strabismus persists, the child must be immediately examined by an ophthalmologist. This is due to the fact that eye deviation can not only be an independent disease, but also be a sign of other diseases (cataracts, glaucoma, congenital uveitis, diseases of the optic nerve, retina). There are two main types of strabismus: friendly And paretic.

Concomitant strabismus usually appears in early childhood. With this type of strabismus, all extraocular muscles function, but for some reason the joint work of the muscles is disrupted. Depending on which muscles have disrupted their joint work, the eyeball deviates in one direction or another. Deviation of the eye inward (toward the nose) is called convergent strabismus, deviation outward (toward the temple) is called divergent, and if the eyeball deviates in the vertical direction, regardless of upward or downward, it is called vertical.

In the case when the eyes “squint” alternately, such strabismus is called alternating, if one eye “squints” - monolateral.

Treatment of concomitant strabismus begins with the definition of refraction. The term refraction refers to the state of the optical apparatus of the eye, which can have several options:

farsightedness or “+”, myopia or “-” or astigmatism - a combination of farsightedness or myopia of varying degrees, or a combination of farsightedness and myopia.

To determine refraction, atropinization is performed (long-term instillation of an Atropine solution). After which the child is examined, refractive indexes are determined. According to the data obtained, correction (glasses or contact lenses) is prescribed. Determining refraction and prescribing correction for concomitant strabismus is necessary to identify another group of varieties of this disease: accommodative, partially accommodative or non-accommodative.

If strabismus disappears when wearing glasses or contact lenses, it is called accommodative, if it is not corrected by glasses - non-accommodative, and when these two forms are combined, strabismus is called partially accommodative. (see photo)

accommodative strabismus (disappears when wearing glasses)

partially accommodative strabismus (does not completely disappear when wearing glasses)

Accommodative strabismus does not require surgical treatment!

Non-accommodative or partially accommodative conditions are subject to surgical treatment.

The timing of surgical treatment is determined by the ophthalmologist. The most optimal age for treating strabismus is 4-6 years. It is necessary to pay attention to the fact that quite often several stages of surgical treatment are required.

There is another important point in the tactics of treating concomitant strabismus. In the monolateral variant, when only one eye “squints,” amblyopia very often develops. This condition is associated with a lack of visual load on the deviated eye, so it does not develop and visual acuity is low. Amblyopia can vary in degree depending on how long the eye has been deviating. The more the eye squints, the more pronounced the amblyopia is.

In severe cases, it requires serious complex treatment, but the most important thing is temporary closure (occlusion) of the healthy eye so that the patient can work. The sooner it starts amblyopia treatment. the better the effect (higher visual acuity). Optimal terms from 1 year to 7-8 years. Treatment of amblyopia takes a fairly long period of time and requires a lot of perseverance and patience from parents. The goal of treating amblyopia is to achieve good visual acuity and, thus, transform the monolateral type of strabismus into an alternating one, which is the key to successful surgical treatment in the future.

Another type of strabismus paretic. characterized by the fact that the work of any oculomotor muscle or group of muscles is impaired. This may most often be due to a violation of the innervation of the muscle. There are a large number of variants of such strabismus, including the so-called atypical forms (vertical, Duan and Brown syndrome, hyperfunction of the inferior oblique muscles).

This variant of strabismus may not even appear at first glance, i.e. not be constant or appear only when the eyeballs move in one direction or another. One of the variants of such strabismus - paresis of the superior oblique muscles with hyperfunction of the inferior oblique muscles - is presented in the photo.

Condition before surgery

The position of the eyes in a straight position is correct, but the eye movements are not symmetrical. When looking to the side, for example, to the right, the eyeball also deviates upward (pronounced hyperfunction of the inferior oblique muscle).

Condition after surgery

Eye movements became symmetrical. The upward deviation of the eye when looking to the side disappeared.

Like any surgical treatment, surgery for strabismus can have complications. The most common complication is hypercorrection of strabismus, i.e. deviation of the eyeball in the opposite direction - can develop at different times, both immediately after surgery and several years later.

Most often, this condition develops in adolescence, and the operation was performed at the age of 4-5 years for convergent strabismus. There is no need to be afraid of this complication, as it is quite easy to correct surgically. (see photo)

Condition before surgery Condition after surgery

A revision of the operated muscles is performed and they are transplanted to the original place of attachment and the secondary divergent strabismus disappears.

The ultimate goal of complex treatment of strabismus is the formation of binocular vision, i.e. vision with two eyes.

The optimal time for surgical treatment is 3-7 years. During this period, children tolerate surgery quite easily. Children in adolescence, even with monolateral (one-sided) strabismus, are often bothered by double vision. It is better to operate on the child before he goes to school. In this case, there will be no difficulties in his social adaptation. Surgical treatment of strabismus, especially complex forms, is usually carried out in several stages (operations).

The intervals between stages are usually from 3 to 6 months. During this period, scarring of the operated muscle is completed, and new relationships between the eyes are formed. The intervals between the stages of operations should not be very long, since with a long-term small angle of strabismus, an abnormal connection between the eyes is often formed (abnormal correspondence of the retina). In this case, the brain believes that the position of the eyes is correct. In this case, a repeated operation may not give the desired result, since after it double vision occurs, and after a certain period the eyes return to their original position.

Our department provides consultations for patients with any form of strabismus. We can give qualified recommendations on conservative and surgical treatment.

If it seems to you that your child has strabismus, if he is squinting and has been undergoing treatment for a long time, if he has already been operated on and the result of the operation does not satisfy you, we are waiting for you in our department.

Information regarding consultation and hospitalization, as well as the cost of surgical treatment and consumables, can be found in the appropriate sections.

Please tell me, a 5-year-old child was told that he needs to have an operation; his left eye is squinting. I would like to know if it can be corrected only surgically? And how much will it cost? Thank you!

Hello, I'm 18 years old. I have strabismus in my right eye. Sometimes I can see it and sometimes I can’t see it. Please tell me if laser surgery is performed and how much it will cost. Is it dangerous to do laser surgery? Thank you

This requires a repeat operation. Unfortunately, the possibility of helping can only be decided in the operating room, when studying the altered anatomy of the eye muscles. Sign up for consultation and surgery on the website.

Good day. When I was 5 years old, I suffered an injury to my left eye, the foreign body was removed, and a week later it became infected, and the lens had to be removed. In your hospital, I was given an artificial lens at the age of 16. During all this time, while my eye was not seeing, it became squinted. After the operation, my eye became more responsive when moving left to right. He came then removed the stitches and did a computer operation to increase the sensitivity of movement and reflexes. I still dream of someday having surgery to correct strabismus, people’s views, etc. etc. already got it. After the operation, vision did not return 100%; if you have surgery, how long do you think the effect will last? or he will squint again. and how much does the operation cost at the moment. the second question, probably technology has long moved forward, if it is possible to perform the operation again and install a better lens that will return vision close to good, and how much do they cost now. Thanks in advance for your answer.

The cost of surgery to correct strabismus is currently 11,400 rubles. The duration of the postoperative effect varies significantly for many reasons. Regarding the replacement of an artificial lens. In short, such an operation will be denied to you. And the point here is not in modern technologies, but in the high traumatic nature of this procedure, unjustified risks and many complications. Sign up for diagnostics and possible surgical treatment on the website.

Thanks for the answer. There is one more question, scheduling a diagnostic appointment with you, how long you need to wait in line, and upon arrival on the same day you can make it or not. and how quickly it all happens. I live in the city of Naberezhnye Chelny, getting there is not a problem. Is it possible to make an appointment for a consultation only on weekdays? You had an operation before, although it was 14 years ago, my data and medical history were probably not preserved, the fact is that honey. They lost the book at the clinic a long time ago, but in the new one there are only acute respiratory infections. I can only retell the story in words.

There is no queue for registration. There is a waiting list during diagnostics at the clinic. Contact us at a time convenient for you, taking into account our work schedule. The old card is no longer in the registry - they are stored for 5 years from the date of the last application. On the day of your visit, you undergo diagnostics and surgery; if indicated, the next day.

Surgery to correct strabismus is possible. The cost today is 11,400 rubles (price of 1 eye). Sign up for diagnostics and possible surgical treatment on the website.

Good afternoon. My daughter is 2 years old. She was born premature at 35 weeks. Since the age of one year, a decreasing horizontal strabismus has been observed. Every day, according to the doctor’s recommendation, we tape the eyes alternately. The effect is zero. Please tell me effective methods of treatment and at what age is it recommended to have surgery. Otherwise, our district doctors only know treatment by closing the eyes!

Also, if there is ametropia, for example, farsightedness, constant wearing of glasses and, possibly, hardware treatment is indicated. Surgeries for strabismus are usually performed from the age of 2 years.

When one or the other eye alternately “squints,” such strabismus is called alternating. The cost of surgery to correct strabismus in 1 eye is 12,200 rubles. After the operation, the hospital stay is, on average, about 2 days. Sign up for diagnostics and possible surgical treatment on the website.

The cost of surgical correction of strabismus for 1 eye is 12,200 rubles. You will be able to return to work 10-14 days after the operation. With high vision, as in your case, the postoperative effect is quite stable and relapse of strabismus, as a rule, is not observed. Sign up for diagnostics and possible surgical treatment on the website.

Please tell me, I have been diagnosed with astigmatism since childhood. One eye sees 100 percent, the other (which squints at times) no longer sees the third line from the top on the oculist’s stand. Can I just correct a slight squint in one eye or will I need to treat the astigmatism first? I am 30 years old. And if you can simply cure strabismus, will it be an operation and how long will the result last? Is it necessary to stay in hospital?

It is possible to perform strabismus surgery for cosmetic purposes. Staying in a boarding house after this surgical procedure is 1-2 days. The current cost is 12,200 rubles. Considering the presence of amblyopia. it is not possible to help with it at your age; a recurrence of strabismus in the future is not excluded. As a rule, the postoperative effect in such cases lasts, on average, for 5-6 years. Sign up for diagnostics and possible surgical treatment on the website.

Thank you very much for the answer. I would like to clarify. Amblyopia at my age cannot be treated even with laser? And is it possible for a slight strabismus to progress in my case if there is no vision at all? Is it too late to put a patch on your healthy eye? Or is it still necessary to preserve at least such vision of the lazy eye (so that it doesn’t get worse)?

There are no effective ways to treat amblyopia at your age: by the age of 7-8 the visual system is fully formed, and it is not possible to influence brain connections. To prevent recurrence of strabismus. After its prompt elimination, you may be recommended a special set of exercises.

Hello, my 5-year-old daughter was diagnosed with converging strabismus of the left eye and amblyopia at the age of 1.3 months. The right eye sees 100%. He has been taking classes on machines every three months for a year now; he refuses to wear glasses or close his eyes. There are no changes for the better or for the worse. Tell me, will it be possible to have surgery? Is there a risk of things getting worse after surgery? I heard that after some time it will be necessary to have surgery on the other healthy eye? Do your specialists travel to Syzran for consultations? Thanks in advance for your answer!

Squint surgery is possible. However, its implementation does not exempt you from further wearing glasses and using adhesives. This is necessary to prevent the development of amblyopia and the formation of binocular vision. There is no need to operate on the healthy eye. Regarding consultation in Syzran, you need to contact your regional representative.

Tell me if they can surgically remove my strabismus, my left eye is squinting, well, not so much, but the left eye that is squinting sees poorly, but I can see perfectly with my right eye, and when I close my right eye, it immediately becomes difficult to look, and my head starts to hurt (I can’t do it for long) So, will they be able to take my strabismus and how much does it cost today?

Hello, my right eye has been squinting since childhood, sometimes very badly, is it possible to correct this 100%? and how much will this cost. and where is your clinic? Thank you.

Operation - correction of strabismus

Surgery to correct strabismus is aimed at restoring normal function of the muscles of the eyeball. The causes of such incorrect positioning of the eyeballs are weakening or, conversely, severe muscle tension. During surgical therapy, the doctor strengthens or weakens a certain group of muscles, which leads to a normal central location of the eyeball. Surgical treatment of strabismus is prescribed regardless of age. When such therapy can be carried out, the doctor determines after a complete ophthalmological examination.

Types of surgical intervention

Depending on what needs to be done with the eye muscles, strabismus surgery can be of two types:

Weakening. During this type of surgery, the site to which the muscle is attached is transplanted to a further distance from the cornea. Due to this, the influence of the muscle tissue that deviates the eye from the center of the axis is weakened.
Strengthening. This operation removes strabismus by excision (shortening) of the muscle, while its location remains the same.

It should be noted that what type of surgical intervention will be performed is determined only during treatment by an ophthalmologist.

It takes many factors into account:

patient's age;
features of the location of muscle fibers;
angle of strabismus;
general condition and features of eye movement, etc.

In most cases, correction affects several muscle groups at once (especially when it comes to adult patients), and sometimes both eyes require surgical intervention.

If the ophthalmologist decides on a combination of two methods of surgery, it is often carried out in stages.

Features of surgical treatment of strabismus depending on age

Often, surgery to correct strabismus in adults is performed under local anesthesia. After this, the patient spends no more than one day in the clinic under the supervision of medical workers.

The correction made gives a positive result. But in practice, after surgery, unpredictable behavior of muscle fibers is possible, which can lead to residual strabismus. This is more common in adult patients, so repeated treatment or a set of exercises are often prescribed that are aimed at stabilizing the functioning of the eye muscles. The next surgical intervention is scheduled no earlier than 6 months later.

In order for the effectiveness of surgical intervention in adults to be as effective as possible, a person needs to fulfill a number of conditions:

if the doctor has decided that the correction should be gradual, one should not insist on the opposite and rush things;
fully adhere to all post-operative instructions given by the medical staff;
For adult patients, it is advisable to carry out simultaneously weakening and enhancing measures.

Surgical intervention is aimed at correcting the position of the eye; it should not disrupt the connection between the eyeball and the muscles.

The most optimal age for such correction in children is considered to be from 4 to 5 years. Congenital strabismus is characterized by a significant angle of deviation of the eyeball from the center, so surgical intervention can often be prescribed earlier. But the time when the child, after surgery, consciously understands and does the exercises prescribed by the doctor is considered more effective and efficient.

Unlike the course of surgery in an adult patient, general anesthesia is used for a child, and the period of hospitalization, depending on the condition, can be extended by several days.

Are there complications?

Strabismus surgery, like any other surgical procedure, has its own postoperative complications. But it should be noted that the capabilities of modern ophthalmology (minimally invasive and carried out with a laser) have significantly reduced the possibility of their occurrence.

One of these complications, which in principle is not such a thing, is considered to be residual strabismus. After a successful operation, only 15% of the total number of patients may experience this condition.

The intervention itself does not affect visual acuity in any way, since it affects only the muscle group that regulates eye movement.

Of course, it cannot be ruled out that an infection may occur during the operation. But to avoid this, doctors prescribe drops containing an antibiotic, which promote normal healing and prevent the development of pathogenic microflora. Therefore, the percentage of such complications is very low.

If during the postoperative period the patient complains of double vision (diplopia), then this condition cannot be called a complication. This is a completely normal condition that passes over time and indicates a restructuring of the body and the restoration of binocular vision. In some cases, for faster recovery, the patient is prescribed hardware treatment.

Surgical intervention aimed at correcting strabismus will help anyone get rid of this aesthetic problem and will not affect visual acuity in any way. Therefore, there is no need to be afraid of this.

Strabismus can be congenital or may also result from exposure to various factors. And although some consider strabismus only an aesthetic problem, in fact, this pathology can provoke the formation of many unpleasant consequences. It is very important for the patient not only to diagnose the disease in a timely manner, but also to begin solving this problem as early as possible. Squint surgery is a radical and effective method.

Strabismus and its consequences

Strabismus is diagnosed if there are existing deviations in the parallelism of the visual axis of the eyes. More often, the patient has only one eye squinting. In some cases the deviation is symmetrical. There are several types of strabismus and there are also several ways to solve the problem: wearing special glasses, disconnecting one eye organ, surgery.

Important: Most experts are inclined to ensure that surgical intervention is performed in extreme cases. To begin with, it is recommended to try conservative methods of correcting strabismus.

What are the dangers of strabismus? Complete loss of vision of an eye organ that has abnormalities. In this case, the brain stops receiving three-dimensional images, and the images do not correspond to each other. The nervous system gradually blocks data received from the defective eye organ. His muscle tone begins to be lost. The functioning of the eye deteriorates greatly over time and amblyopia develops in 50% of cases.

Reasons for the formation of strabismus

Strabismus can be acquired or congenital. The formation of each of them has its own reasons for its occurrence. Eg.

Acquired type of strabismus

Most often, this type of strabismus develops in children before they reach six months. A significant role in this case is played by existing diseases that provoked such a side effect. But there are frequent episodes of the development of strabismus in the older century category. The most common causes of acquired strabismus are:

strabismus as a result of sharply deteriorated vision with astigmatism, farsightedness, and myopia;
refractive errors of the eye can be caused by developing cataracts or glaucoma, and as a result, strabismus is formed;
paralysis of the eye muscles can cause psychological disorders, as well as somatic diseases (for example: neurosyphilis, encephalitis);
a mild degree of strabismus can be provoked by disturbances in blood circulation and sudden surges in pressure, and if the pathology is ignored, disability;
Experts consider childhood diseases such as scarlet fever and measles to be provoking factors for the development of strabismus.

Important: In cases where the child had a predisposition to strabismus, the pathology can manifest itself as a complication after suffering from diphtheria or influenza.

Strabismus can develop in preschool children after severe fright, as well as as a result of psychological trauma. These reasons for the development of pathology were also recorded in older patients. Although in more rare cases.

Congenital type of strabismus

In practice, congenital strabismus is very rare. It is even less common to find it in its pure form, that is, immediately at the birth of the baby. The manifestation of pathology in the first six months of a baby’s life is established as infantile. More often, a newborn has an imaginary strabismus. Children of this age are unable to accurately focus their gaze, and at the same time it seems that the child is developing a pathology.

Interesting: Imaginary strabismus can also be observed in adults when a person is in a state of severe intoxication.

Infantile strabismus often develops due to genetic disorders and during the period when the fetus is still in the womb. This can be caused by the following diseases: cerebral palsy, Crouzon or Down syndrome, as well as hereditary predisposition. In cases of heredity, one of the baby’s relatives also has similar deviations.

At risk are babies whose mothers suffered from infectious diseases during pregnancy, used narcotic drugs, as well as medications without specialist prescription.

Is surgery for strabismus the only solution to the problem?

Surgery to eliminate strabismus is a radical method of solving the problem. Immediately after diagnosis, the specialist will offer conservative treatment methods, which are more gentle methods. These may be special glasses. Their task is to force both eye organs to focus on one point. Over time, the muscles of the damaged eye develop. The pathology is gradually being corrected.

If a patient has one organ affected, an “ocular organ disconnection” procedure may be suggested. For these purposes, a special bandage is placed on the healthy eye. Thus, the brain begins to receive images only from the diseased organ. The muscles gradually develop and the pathology is corrected.

Surgery is recommended in more advanced cases. It cannot guarantee complete restoration of lost vision, but it allows for a more symmetrical relationship between the eye organs. More often, young people agree to undergo surgery, for whom it is very important to have no defects in appearance.

Indications for surgery

The patient used all conservative treatment methods, but no improvements were achieved (or they were not achieved to the maximum extent).
The patient wishes to eliminate cosmetic defects as soon as possible. Conservative treatment can last several months, or even years.
The patient has severe defects. The doctor considered it more expedient to first restore vision through surgery, and only then apply conservative methods to fix or improve the previously obtained result.

Important: Surgery may be contraindicated only in cases where the patient has individual characteristics that are previously discussed with his specialist.

There are also some age restrictions. For example, the optimal age for surgical intervention is considered to be 4–5 years old for a child. Younger patients may be turned away. The exception is the congenital form of strabismus, which is corrected at 2–3 years of age. This is explained simply. After surgery, the patient must adhere to a special regime and perform special exercises. Children under 4 years old will not be able to do this consciously and independently. The chances that the pathology will return significantly increase.

Principles and types of surgery to eliminate strabismus

Surgery to correct strabismus is carried out in several types of operations. Sometimes a specialist selects one optimal option for a given situation, but more often during the operation several types are combined with each other. More details about each type.

Muscle recession involves cutting off tissue from its physiological attachment site. After cutting, the muscle is sutured. The specialist selects the optimal location for its future attachment. This may be a tendon, as well as the sclera. As a result, the fiber moves back and its effect weakens. If the fiber moves forward, the action of the muscles, on the contrary, increases.
The myectomy operation involves similar manipulations with cutting off the muscle. The difference from the previous type is the absence of a suturing procedure.
Less trauma to the eye organ can be achieved using Faden surgery. In this case, manipulations with cutting off the muscle are not performed. The tissue is immediately sutured to the sclera. This procedure uses non-absorbable threads.
If a muscle is weakened and its action needs to be strengthened, shortening surgery is used. During surgery, part of the muscle is removed.
Another type of operation will help to obtain a similar effect. It involves creating a fold between the tendon and muscle. It is possible that this fold is formed inside the body of the muscle itself.

Any of the selected operations to correct strabismus is carried out in compliance with the main principles. The correction must be gradual. The operation is performed on only one eye organ. In the second, the procedure is repeated several months later (approximately 3–6). Although, with a small mowing angle, the surgeon may decide to make corrections simultaneously in both eyes, but this is often the exception.

Features of the operation

If the patient has severe strabismus, surgery is performed in several stages. The fact is that it is undesirable to perform surgery on more than two muscles at a time.

Lengthening or shortening a muscle must be carried out evenly on all sides. For example, if the muscle on the right contracts in size, then on the left it must necessarily increase. In this case, the dimensions of excision and enlargement are necessarily identical.

Observing all the main principles of surgical intervention, the specialist tries to preserve as much as possible the connection between the eyeball and the operated muscle.

For adult patients, the correction is performed under local anesthesia. Upon completion, the patient is given a bandage. You can go home after just a few hours. For children (of any age), general anesthesia is always used. The child is required to be hospitalized for a day, but cases with a longer hospital stay cannot be excluded.

Those who have the opportunity to correct pathology in foreign clinics should pay attention to German and Israeli specialists. Their approach to such correction is more radical. Almost all types of pathologies are corrected in one visit. Another plus is the possibility of performing the operation on children under one year old.

Rehabilitation period

Although the operation to correct strabismus is performed in one day and the patient is immediately sent home, this does not mean that there is no rehabilitation period. For a quick recovery, you will need to follow certain doctor’s recommendations for some time and perform special eye exercises.

The first day after surgery, the eye organ will be sore, slightly red and inflamed. This is a natural state. There may also be a short-term deterioration in vision. During this period, every movement must be controlled, since any attempts to touch the eye can only result in increasing pain.

Important: Restoration of the tissues of the eye organ and binocular vision occurs after a month. Most patients see a double picture all this time. If vision is not restored after this period, you should consult an ophthalmologist.

In children, adaptation time is significantly reduced. The main thing is to perform the exercises prescribed by a specialist and visit an ophthalmologist.

For active recovery, a specialist may recommend using special corrective glasses, as well as covering the healthy eye from time to time. This will help create stress on the operated organ. The muscles will develop faster and reach the desired level.

What complications should you expect after surgery?

The most common complication that occurs in medical practice after surgery to eliminate strabismus is overcorrection. It is formed when the muscles of the eye organ are excessively lengthened or sewn in. The main reasons for this undesirable effect:

surgeon error;
incorrect preliminary calculations;
the patient’s natural growth, which affects the increase in size of the eye organ.

Recently, experts have found the best way to minimize the risk of such a complication. Increasingly, operations are being carried out not by cutting, but by sewing in muscle folds. In this case, the applied suture is adjustable and the undesirable effect can be corrected in a minimally invasive way.

Formation of a rough scar at the site of muscle cutting and subsequent sewing. This method of surgical intervention deprives the muscle tissue of mobility and elasticity, which is partially replaced by fibrous tissue. The only alternative at this time is to reduce the size of the excised area.

Strabismus returns (relapses) over time. This complication most often occurs due to the fault of the patient himself, who neglects to comply with all the rules in the postoperative period. In children, relapse can occur due to sudden increases in load on the eye organ. For example, an operation to correct strabismus was performed at the age of five or six years, and after a couple of months the child began attending school.

The most serious, but very rare complication is damage during the operation to the vagus nerve, which is responsible for the functioning of the lungs, gastrointestinal tract and heart muscles.

Patient reviews

Mostly, a lot of negative feedback can be heard from parents who decided to have their child have surgery in domestic clinics. They justify their dissatisfaction with the following comments.

Most clinics do not have an individual approach to each patient and the problem at hand.
The refusal of specialists to perform surgical intervention at an early age, and delay results in the progression of the disease and deterioration of vision for the young patient.
Basically, all clinics use outdated techniques and equipment during operations and diagnostics. This does not make it possible to get a 100% result from the first operation. Correction of strabismus is performed with insufficient results and repeated surgical interventions are necessary after a while.
There are few specialists in this profile, which greatly limits patients’ choices.

Most parents note only a temporary positive result. As soon as the school year begins and the child goes to school, vision begins to decline again, and squint returns. This is explained by an increase in eye strain. Many children refuse to wear special corrective glasses at school. To prevent their classmates from laughing, they take them off and hide them secretly from adults. Less time is devoted to special exercises. All these negative factors lead to the fact that young people decide to have a second operation only after graduating from school.

Important: The older the patient, the less successful the surgery to correct strabismus is.

How much does surgery to correct strabismus cost?

The cost of surgery to correct strabismus differs in different clinics. For example, if this is a government agency and the child is a minor, the operation can be performed free of charge. Treatment will also be free for adults, but only those who have a compulsory medical insurance policy. It is also worth noting that some private clinics also work with compulsory health insurance. The operation itself will be free, but additional services may be required that will need to be paid for.

In the case of other private clinics, the price can vary within 20,000 thousand rubles. The price varies depending on the availability of modern equipment in the institution, the professionalism of the doctor, the complexity of the operation itself, etc.

Patients who are thinking of going to a German or Israeli clinic will have to count on about 7 thousand euros. But there is also one nuance here. Visiting a foreign clinic through an intermediary will increase in price (about 2 times).

There are certain problems of the oculomotor system in which the changes leading to the alignment of the eyes during the healing period [after surgery] are quite predictable. For example, when a child undergoes surgery to correct exotropia(divergent strabismus), during the healing period the eyes tend to diverge ( divergence) by an average of 5 degrees. For this reason, for the ideal alignment of the eyes [in the future], in some children immediately after correction surgery exotropia the eyes should be “over-corrected” by a few degrees (they look like exotropic, or squinting inward), so that when the eyes open a little during healing, they become straight. In a person suffering exotropia, the brain is accustomed to diverging eyes ( divergent), and he learned suppress[image of] a deviating eye. He is not used to inward-turned eyes (convergent squint) and “doesn’t know how to suppress” a squinting eye. Consequently, when the eye is turned inward after such surgery, temporary double vision is common and is common. Typically this lasts several days or weeks. If double vision does not go away, it may need to be treated with eye drops, glasses, prisms, or another surgery. In most cases, temporary double vision after surgery for strabismus is predictable and there should be no cause for concern or alarm about it.

Question: My daughter's exotropia. When she looks at me, I see that only her left eye is off center, and I have never seen her have any problems with her right eye. Her doctor wants to perform surgery on both eyes. Why?

Answer: Your doctor's recommendation may be entirely appropriate. Don't think about divergent strabismus Your daughter seems to have a problem only in her left eye. Imagine that both of her eyes are not looking in the same direction, but are moving apart. But when she looks at you, she should use either her right eye or her left. Otherwise, she won't look at you. If her right eye is dominant (just as your right hand may be more coordinated than your left [if you are right-handed]), then given a choice, she will always choose to look with her right eye. Consequently, you constantly see only your left eye as deviating. All you have to do is evaluate her gaze with your left eye (perhaps while covering her right eye), and you may very well see that the right eye deviates as far from center as the left (see again (see Figure 6-2 on page 59). You will never see the left eye deviate on its own because she does not look with the left eye if there is a choice of one eye or the other.

Nowadays, strabismus surgery has become one of the most popular methods of combating this disease. This type of visual impairment is characterized when one or both eyes alternately deviate when looking straight ahead. If the eyes are located symmetrically, then the image of the object in front of the person falls exactly in the center of each eye. Due to this, the picture is combined, and we see three-dimensional objects.

When the eyes look at more than one point, the image begins to double, and the brain has to filter the information transmitted by the squinting eye. If measures are not taken in time, amblyopia may develop, an almost complete functional loss of vision in the eye that is not involved in constructing visual images.

Why do adults develop strabismus?

Strabismus, as doctors call the disease, in adulthood can be a residual manifestation of vision problems that arose in childhood, but acquired ones can also occur. Often doctors cannot determine exactly what caused the development of the disease. These can be either acquired or congenital characteristics of the body:

visual impairments such as farsightedness, myopia, astigmatism;
injuries received;
paralysis;
disturbances in the development and structure of the muscles that move the eyes;
disturbances in the functioning of the central nervous system;
rapid deterioration of vision, affecting only one eye;
consequences of stress or mental trauma;
previously suffered measles, diphtheria or scarlet fever.

What is squint like?

Strabismus can be acquired or congenital. They also distinguish between permanent and non-permanent strabismus, which appears periodically or completely disappears over time. There are two types of this disease.

When both eyes turn away in turn

With concomitant strabismus, as the name suggests, both eyes are affected. They take turns mowing in approximately the same range. The main cause of this vision pathology is ametropia.

Main distinctive features:

if a person looks at a stationary object, then one eye deviates slightly towards the nose or temple;
at the same time, the deviating eye may change;
mobility of the eyeball is preserved in all directions;
a person does not observe double images before his eyes;
the patient lacks binocular vision;
the primary and secondary angle of deviation of the squinting eye are almost the same;
Deterioration of vision in a squinting eye may occur.

As a rule, a person with concomitant strabismus has other visual impairments: myopia or farsightedness, astigmatism.

When only one eye squints

The second type of pathology is paralytic strabismus. The main difference between this type of visual impairment is that the squinting eye does not move or moves limitedly in the direction of the affected muscle. The image begins to double, and the person loses the ability to see in volume. The disease is caused by nerve damage, improper functioning of the eye muscles, tumors and injuries.

Signs of this type of pathology include:

where the muscle is affected, the eye does not move;
The primary and secondary deflection angles are different: the secondary one is larger;
double vision, loss of three-dimensional vision;
dizziness;
forced slight deviation of the head towards the affected eye.

All age categories are susceptible to paralytic strabismus: it can develop at any age.

Other types of strabismus

In addition to the above, there are convergent and divergent (exotropia) strabismus, as well as vertical. In the first case, the squinting eye deviates towards the nose. Convergent strabismus is diagnosed more often in children than in adults; in the process of maturation, it often completely disappears. As a rule, the pathology develops against the background of farsightedness.

Divergent strabismus in adults is characterized by the fact that the eye deviates towards the temple. Pathology occurs with congenital or acquired myopia. With vertical - one eye is directed up or down relative to the healthy one.

Treatment of strabismus

Is it possible to correct squint? The answer is yes. Strabismus can be cured. To do this, use special prismatic glasses, or resort to surgical intervention. As the disease progresses, good vision is retained only in the eye that transmits the image to the brain. The squinting eye begins to see worse over time as the brain suppresses its visual functions in order to achieve a stable and clear image. Therefore, it is extremely important to promptly begin treatment of strabismus in adults as soon as the first signs of the disease are noticed.

To achieve results, both individual methods and complexes of procedures can be used:

use of glasses and contact lenses for vision correction;
treatment of amblyopia using hardware methods;
measures aimed at restoring binocular vision;
surgical intervention.

Surgery

Surgery for strabismus is performed for aesthetic purposes to restore the symmetrical position of the eyes. But surgery itself will not restore vision without comprehensive treatment. The surgeon decides on the method of eliminating the problem directly during surgery. It is possible to determine which way to perform the operation only taking into account the location of the eye muscles of a particular patient. In some cases, both eyes are operated on at once. The main goal of the operation is to bring the deviating eye muscle into the desired position and tone.

After surgical correction, there is no need to wear uncomfortable prismatic glasses. This is one of the main reasons why an ophthalmologist refers a patient to a surgeon. Surgery to correct strabismus can improve the quality of life, remove embarrassment due to the negative perception of strabismus, and restore a good emotional state. The cost of the operation is calculated individually in each case.

Is the operation dangerous?

Eye surgery always involves certain risks. When eliminating strabismus surgically, the negative consequence that occurs most often is double image. Usually it goes away after some time, but there are times when double vision remains. More serious risks include decreased quality of vision, retinal detachment, infections, and problems caused by anesthesia. Fortunately, all of these complications are extremely rare.

An important factor is the general state of health. The better the patient feels, the more successful the operation will be and the faster the eye will recover. In any case, there is no need to worry. The modern level of development of medicine, high-quality equipment and the professionalism of doctors make the likelihood of events developing in a negative way tending to zero.

What results can be achieved with the help of surgery?

Most patients experience significant improvement in vision after surgery. It happens that complete correction of strabismus does not occur immediately, and the body requires a long time to recover after a successfully performed operation. In some cases, repeat surgery may be required. Residual double vision that occurs after surgical procedures is usually eliminated with the help of prismatic glasses.

Patient recovery after surgery: is medical examination necessary?

The first days after surgery, the patient may feel discomfort and headaches, pain when the eye muscles are tense, and a feeling of the presence of a foreign object in the eye. In this case, the doctor prescribes painkillers for him. After just a few days, the unpleasant symptoms go away and the patient can return to active life. However, it is best to avoid heavy exercise for a few more weeks.

Will hospitalization be required after surgery? Depends on the general condition of the patient and the recommendations of his attending physician. Most of the operations are performed on an outpatient basis, and the operated patient returns to normal life within a couple of days.

Postoperative recovery takes, on average, about a week. However, in addition to rehabilitation, a course of hardware treatment may also be required to achieve maximum results and a noticeable improvement in the quality of vision. Vision will be restored over a longer period. Eye exercises and therapeutic procedures will help with this.

Strabismus surgery is available for patients of any age. You can find out how much the operation costs by scheduling a personal consultation with an ophthalmologist. Average prices - from 15,000 rubles to 30,000 rubles per eye. This is a great way to reduce symptoms, correct the aesthetic consequences of strabismus, and simply improve your quality of life. Surgical treatment of strabismus is now considered an effective and safe way to restore vision. Strabismus can be corrected without medical examination and subsequent long-term recovery.

Eye surgery to correct strabismus

What is strabismus, or strabismus?

Acquired strabismus occurs as a result of:

infectious disease: influenza, measles, scarlet fever, diphtheria, etc.; somatic diseases; injuries; a sharp drop in vision in one eye; myopia, farsightedness, high and moderate astigmatism; stress or severe fear; paresis or paralysis; diseases of the central nervous system.

How can you get rid of strabismus?

Strabismus corrects:

wearing special glasses; a series of eye exercises; wearing a blindfold covering one eye; surgery to correct strabismus.

Types of surgeries to correct strabismus

The following types of strabismus occur in children and adults:

horizontal - converging and diverging relative to the bridge of the nose; vertical; combination of two types.

Doctors encounter convergent strabismus more often than divergent strabismus. Along with converging strabismus, the patient may have farsightedness. Myopic people usually have divergent strabismus.

During the operation the following can be performed:

amplification type surgery; debilitating surgery.

In weakening surgery, the eye muscles are transplanted a little further from the cornea, which tilts the eyeball in the opposite direction.

Carrying out the operation

For a month after surgery, you need to carefully protect your eye. You cannot swim, be in dusty rooms or play sports. Children at school are exempted from physical education for six months.

Source: Types of surgical intervention for strabismus

Types of surgical intervention for strabismus

The main task of any surgical intervention for strabismus should be considered to be the restoration of the correct balance between the eye muscles responsible for the movement of the eyeball.

During augmentation surgery, the eye muscle is shortened due to:

formation of a special fold at the site of the tendon (tenorrhaphy); moving the attachment point of the muscle to the eyeball (anteposition).

Relieving surgery to correct strabismus aims to relieve excess tension and weaken the eye muscle by:

changes in its place of attachment to the eyeball (recession); its extension (plastic); ineffectiveness of non-surgical treatment carried out over a long period of time; very strong degree of strabismus; non-accommodative strabismus.

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Each of these periods is of great importance for the favorable outcome of the operation.

The operation itself involves highly technical manipulations by a competent ophthalmologist to establish the correct balance between the patient's eye muscles in order to restore symmetry in the placement of the eyes. The operation is performed using painkillers.

Postoperative recovery can take a different period of time in different patients. It consists of strict adherence to all recommendations of the attending physician for the elimination of:

eye discharge; double vision, etc.

It is important to understand that in order to eliminate strabismus, the operation must be performed at a strictly defined time, determined by the doctor. You can't put it off, because... The level of vision may significantly decrease. We must not allow events to be forced, which would have a negative impact on its outcome. In some cases, surgery consists of several necessary steps.

After surgical removal of strabismus, various complications may arise, the elimination of which will require additional eye treatment or repeated surgery. The main complications of this kind should be considered:

excessive vision correction;

Source:

Strabismus

Types of surgeries to correct strabismus

To achieve maximum effectiveness when performing surgery to correct strabismus, you must adhere to several basic principles.

2. If it is necessary to weaken or strengthen individual muscles, dosed surgical intervention should be distributed evenly.

3. When performing surgery on a specific muscle, it is necessary to maintain its connection with the eyeball.

High-tech strabismus surgery:

Specialists from children's eye clinics have developed modern high-tech radio wave surgery using the principles of mathematical modeling.

Advantages of high-tech eye surgery:

The operations are low-traumatic; thanks to the use of radio waves, the structures of the eye are preserved.
After the operations there is no terrible swelling, the patient is discharged from the hospital the next day.
Operations are precise.
Thanks to the principles of mathematical calculation, we can ensure the highest accuracy and show the guaranteed result of the operation even before it is carried out.
The rehabilitation period is reduced by 5-6 times.
General provisions when performing operations for strabismus

enhancing;
weakening.
excision of some portion of it (resection);
excision of part of the muscle fibers (partial myotomy).
paralytic strabismus;
preoperative preparation;
the actual operation;
postoperative recovery.
redness of the eyes;
discomfort and pain with sudden movements, in bright lighting;
various inflammatory processes in the operated areas.
reduction of the strabismus angle before pleoptic or orthoptic treatment,
preventing the development of contracture of the external muscles of the eye with a large amount of strabismus,
for the purpose of functional cure for strabismus,
for cosmetic purposes when it is impossible to improve vision or teach correct binocular vision.
Weakening. During this type of surgery, the site to which the muscle is attached is transplanted to a further distance from the cornea. Due to this, the influence of the muscle tissue that deviates the eye from the center of the axis is weakened.
Strengthening. This operation removes strabismus by excision (shortening) of the muscle, while its location remains the same.
patient's age;
features of the location of muscle fibers;
angle of strabismus;
general condition and features of eye movement, etc.
if the doctor has decided that the correction should be gradual, one should not insist on the opposite and rush things;
fully adhere to all post-operative instructions given by the medical staff;
For adult patients, it is advisable to carry out simultaneously weakening and enhancing measures.

Strabismus and its consequences

Important: Most experts are inclined to ensure that surgical intervention is performed in extreme cases. To begin with, it is recommended to try conservative methods of correcting strabismus.

Reasons for the formation of strabismus

Strabismus can be acquired or congenital. The formation of each of them has its own reasons for its occurrence. Eg.

Acquired type of strabismus

strabismus as a result of sharply deteriorated vision with astigmatism, farsightedness, and myopia;
refractive errors of the eye can be caused by developing cataracts or glaucoma, and as a result, strabismus is formed;
paralysis of the eye muscles can cause psychological disorders, as well as somatic diseases (for example: neurosyphilis, encephalitis);
a mild degree of strabismus can be provoked by disturbances in blood circulation and sudden surges in pressure, and if the pathology is ignored, disability;
Experts consider childhood diseases such as scarlet fever and measles to be provoking factors for the development of strabismus.

Important: In cases where the child had a predisposition to strabismus, the pathology can manifest itself as a complication after suffering from diphtheria or influenza.

Congenital type of strabismus

Interesting: Imaginary strabismus can also be observed in adults when a person is in a state of severe intoxication.

At risk are babies whose mothers suffered from infectious diseases during pregnancy, used narcotic drugs, as well as medications without specialist prescription.

Is surgery for strabismus the only solution to the problem?

Indications for surgery

The patient used all conservative treatment methods, but no improvements were achieved (or they were not achieved to the maximum extent).
The patient wishes to eliminate cosmetic defects as soon as possible. Conservative treatment can last several months, or even years.
The patient has severe defects. The doctor considered it more expedient to first restore vision through surgery, and only then apply conservative methods to fix or improve the previously obtained result.

Important: Surgery may be contraindicated only in cases where the patient has individual characteristics that are previously discussed with his specialist.

Principles and types of surgery to eliminate strabismus

Muscle recession involves cutting off tissue from its physiological attachment site. After cutting, the muscle is sutured. The specialist selects the optimal location for its future attachment. This may be a tendon, as well as the sclera. As a result, the fiber moves back and its effect weakens. If the fiber moves forward, the action of the muscles, on the contrary, increases.
The myectomy operation involves similar manipulations with cutting off the muscle. The difference from the previous type is the absence of a suturing procedure.
Less trauma to the eye organ can be achieved using Faden surgery. In this case, manipulations with cutting off the muscle are not performed. The tissue is immediately sutured to the sclera. This procedure uses non-absorbable threads.
If a muscle is weakened and its action needs to be strengthened, shortening surgery is used. During surgery, part of the muscle is removed.
Another type of operation will help to obtain a similar effect. It involves creating a fold between the tendon and muscle. It is possible that this fold is formed inside the body of the muscle itself.

Features of the operation

If the patient has severe strabismus, surgery is performed in several stages. The fact is that it is undesirable to perform surgery on more than two muscles at a time.

Observing all the main principles of surgical intervention, the specialist tries to preserve as much as possible the connection between the eyeball and the operated muscle.

Rehabilitation period

Although the operation to correct strabismus is performed in one day and the patient is immediately sent home, this does not mean that there is no rehabilitation period. To quickly restore binocular vision, you will need to adhere to certain doctor’s recommendations for some time and perform special eye exercises.

Important: Restoration of the tissues of the eye organ and binocular vision occurs after a month. Most patients see a double picture all this time. If vision is not restored after this period, you should consult an ophthalmologist.

In children, adaptation time is significantly reduced. The main thing is to perform the exercises prescribed by a specialist and visit an ophthalmologist.

What complications should you expect after surgery?

surgeon error;
incorrect preliminary calculations;
the patient’s natural growth, which affects the increase in size of the eye organ.

The most serious, but very rare complication is damage during the operation to the vagus nerve, which is responsible for the functioning of the lungs, gastrointestinal tract and heart muscles.

Strabismus occurs quite often. In young children, such a defect can sometimes look touching and funny, but the impairment should not be underestimated. At any age, this is an unpleasant pathology that needs to be corrected - both from a medical point of view and from an aesthetic point of view. Although in the vast majority of cases children are susceptible to the disease, adults are not protected from it either.

In children, strabismus is, of course, easier to correct, especially if it is detected at the very beginning of development and treatment is started in a timely manner. Strabismus causes a lot of inconvenience to the patient; a squinting eye can completely “fail” over time, not to mention psychological and aesthetic discomfort. Fortunately, diagnosing strabismus is very simple, and modern medicine provides a whole arsenal of means for its treatment, including surgery, if necessary.

What is strabismus

Strabismus (other names: strabismus, heterotropia) is a very common ophthalmological disorder. According to statistics, one child in fifty suffers from it. associated with uncoordinated activity of one or more ocular muscles responsible for the movement of the eyeball.

If normally the eyes focus on a certain point, transmitting an image from each eye to the brain, then with strabismus as a result of muscle weakness, one eye deviates from this point, the image received from one eye does not correspond to the image received from the other. Because of this, the nervous system excludes the picture received from the squinting eye, and a three-dimensional image is not created in the brain. As a result, a person sees a flat image, and the eye that squints almost does not participate in the visual process and stops working. Because of this, amblyopia, or lazy myopia, “lazy eyes,” as squint in children is sometimes called, develops over time.

The causes of the disease may be different, but in any case, if the diseased eye is not treated, it becomes weak and is completely excluded from participation in the visual process.

Types of strabismus

The reasons may vary. As for strabismus, ophthalmologists consider congenital and acquired diseases.

By type, strabismus is divided into friendly and unfriendly.

Causes of congenital strabismus

In fact, pure congenital strabismus occurs in isolated cases. If strabismus develops in the first six months of life, it is called infantile. In such cases, the causes of the disease are genetic disorders, such as Crouzon syndrome and Down syndrome; heredity - in this case, strabismus is diagnosed in first- and second-degree relatives; congenital eye defects, cerebral palsy. Often the disease appears as a result of the consequences of prematurity, the effects of various medications and drugs on the fetus, and if the mother suffered infectious diseases during pregnancy (measles, cytomegalovirus, ARVI and some others), this can also cause strabismus in the child.

Causes of acquired strabismus

The disease can develop after the first six months of life and even in an adult. In this case, it is called acquired.

There are many causes of acquired strabismus. First of all, the disease is provoked by medium and high degrees of myopia, farsightedness, astigmatism and sudden changes in vision without noticeable reasons. Strabismus can also develop due to various eye conditions: glaucoma, cataracts, astigmatism and others. In addition to various eye diseases, including retinoblastoma, strabismus after injury, tumors and other injuries.

Strabismus is a consequence of muscle paralysis, which accompanies certain diseases, such as encephalitis, multiple sclerosis, neurosyphilis, as well as somatic and mental illnesses. In addition, it is acquired if there is insufficient blood supply, intracranial pressure rises sharply, and pathologies of the brain or spinal cord develop. Strabismus can manifest itself as complications after influenza, measles, scarlet fever, and diphtheria.

It can also cause strabismus in children. Reasons of a psychological nature, stressful situations, psychological trauma, nervous overstrain quite often lead to the fact that preschoolers (and sometimes older children and even adults) begin to squint their eyes.

Concomitant strabismus

Friendly is a disease in which the angles of strabismus are the same. That is, one eye is squinting, but the angle of deviation of the squinting eye (primary) and the angle of deviation of the healthy (secondary) eye are equal. Despite the fact that the muscular system of the eyes is developed differently, there is no double vision, both eyeballs are fully mobile.

Concomitant strabismus is divided into three groups of visual disturbances:

Accommodative.

Non-accommodative.

Partially accommodative.

With accommodative strabismus, the disease is accompanied by some kind of vision pathology - farsightedness or myopia. This type of strabismus develops between 2 and 4 years of age. Corrected by wearing glasses.

Paralysis of the muscles responsible for eye movement causes non-accommodative strabismus. may lie in problems during intrauterine development or diseases suffered after birth. This type of strabismus is difficult to identify at the initial stage. It often accompanies cerebral palsy.

horizontal (when the eyes are directed in different directions - exotropia, or divergent strabismus; when the eyes are directed to the bridge of the nose - isotropy, or convergent strabismus);
vertical (when the eye squints upward - hypertropia, when the eye squints downwards - hypotropia);
mixed (when several forms of strabismus are combined).

This type of strabismus cannot be corrected with glasses.

Types of non-accommodative strabismus:

sensory (with loss of vision in one eye);
acute (strabismus that suddenly appears after stress, psychological trauma or nervous tension);
cyclical (strabismus appears and disappears after a certain period of time, the reason lies in disorders of the central nervous system);
secondary (squint that has changed direction to the opposite after surgical or spectacle correction).

There is also a special type of non-accommodative strabismus - excess of divergence. In this case, strabismus appears only when a person peers into the distance.

Partially accommodative strabismus combines symptoms of accommodative and motor disorders, such as oscillations of the eyeballs, which appear involuntarily and regularly. It can be convergent (when the eyes are focused on the bridge of the nose) and divergent (the eyes “look” at the temples).

Strabismus can have varying degrees of severity:

strongly rendered has an angle greater than 37 degrees,
clearly visible has an angle of 22-36 degrees,
average - 11-21 degrees,
slight - 6-10 degrees,
practically unexpressed - angle less than 5 degrees.

Unfriendly strabismus

In non-conjugate strabismus, the primary and secondary angles of deviation are not the same. Eye mobility is limited or absent in one or more directions. Most often, this strabismus also has a paralytic nature of origin, as a non-accommodative type. The causes of this disease are damage to the oculomotor nerves.

There is also pseudoparalytic strabismus. The causes of visual impairment in this case are developmental anomalies or after surgery, but not nerve damage.

Imaginary strabismus

All types of strabismus that have been described are true. They should not be confused with imaginary strabismus, which occurs in young children. Because of their age, they are often unable to focus their gaze on an object, which creates the appearance that the child is squinting.

However, imaginary temporary strabismus sometimes happens to adults. This usually occurs due to alcohol intoxication.

Diagnostics

Even if it seems that strabismus is practically invisible or harmless, you should not delay treatment. This is not a cosmetic defect at all, so it requires immediate attention as soon as it is discovered. If strabismus is not corrected, the eye may lose the ability to see.

The first symptoms of strabismus:

deviation of one or both eyes towards the nose (convergent strabismus) or to the side (divergent strabismus),
inability to focus on an object (the so-called floating gaze).

In this case, you need to take into account many details so as not to confuse the disease with an imaginary one. A special or specific location, characteristic of a particular child, can be mistaken for strabismus. Here it is important to distinguish real symptoms of strabismus from imaginary signs. These physiological signs most often disappear on their own with age. A floating gaze can also be found in infants under six months of age who cannot yet focus on an object. This also goes away with age. There are many parents who began to panic, suspecting strabismus in children under one year old; their worries were dispelled either by specialists or by the disappearance of symptoms at a later age.

Often parents themselves notice strabismus and contact an ophthalmologist. This is a disease that you can actually diagnose on your own, without the help of a specialist.

The disease can also be detected during a routine examination of the child. The eye doctor diagnoses the entire visual system, including using a computer, and conducts tests confirming the absence of three-dimensional vision and that the child has strabismus. The causes of the disease must be determined in order to prescribe treatment appropriate for this type of problem.

The doctor selects glasses or lenses, prescribes hardware treatment and, if necessary, medications. In difficult cases, he may refer you for surgery to an ophthalmology clinic.

If you start treatment at an early stage of development, in most cases it is possible to completely get rid of the disease.

Non-drug treatment

In some cases, strabismus can be corrected with glasses or contact lenses. This method is indicated for accommodative and partially accommodative strabismus.

For partially accommodative strabismus, Fresnel prisms - complex composite lenses - are glued onto the lenses of the glasses.

The pleoptics method, that is, occlusion treatment, is also successfully used. In this case, a bandage or eye patch is applied to the healthy eye. Treatment should last at least 4 months and is indicated mainly in the treatment of childhood strabismus. With this method, it is necessary to constantly monitor the visual acuity of the healthy eye undergoing constant sealing. To make treatment more effective, pleoptics is combined with hardware correction, which includes laser therapy, amblyocor, electrical stimulation and other methods.

Drug and hardware treatment

The drugs are prescribed in conjunction with hardware treatment and eye exercises and either relax muscles and dull vision, like atropine, or, like pilocarpine, prevent pupillary constriction. The essence of the treatment is to increase the load on the eye and stimulate its active work.

Hardware is also effective in treating the disease. Devices such as monobinoscope and synoptophore are used. The first irritates the retina with light rays and thereby fights amblyopia (reduced vision) and double vision. The second is used for sensory strabismus if the angle of strabismus is large enough.

Patients are also indicated for orthopto-diploptic treatment, which consists of training exercises on devices. This treatment is aimed at developing binocular vision.

Surgery

In some cases, surgical intervention is recommended for strabismus. Thanks to it, the muscle that is responsible for the movement of the eyeball is strengthened or weakened. Strabismus surgery is used if complex treatment does not help. It is also indicated for paralytic and non-accommodative forms.

In case of strongly visualized strabismus, several operations can be performed on each eye with a break of at least six months.

In case of strabismus, two types of operations are performed: resection, which shortens the length of the eye muscle, and recession - movement of the eye muscle. The choice of the nature of the operation depends on the type of strabismus and its angle. A combined intervention can also be performed. Surgeries are performed under both general and local anesthesia.

It is worth remembering that strabismus is not surgically corrected until the age of 3-4 years. It is necessary to wait until binocular vision is formed, that is, the ability to see the image of an object with both eyes. At an earlier age, surgical intervention is possible only if there is congenital strabismus with a significant angle of deviation. Only an eye surgeon can perform such operations.

After surgery, treatment should be continued with any of the above methods to restore and strengthen binocular vision.