Strabismus is a misalignment of the eyes, often called crossed eyes or a squint. This condition occurs when the six extraocular muscles surrounding each eye do not work together properly, preventing both eyes from focusing on a single point simultaneously. Strabismus surgery corrects this misalignment by adjusting the tension or position of one or more of these exterior eye muscles. The operation aims to achieve better cosmetic alignment and improve binocular function, which is the ability of the eyes to work together.
Duration of the Procedure
The actual surgical time, during which the patient is under anesthesia, is generally brief. A typical strabismus procedure lasts between 30 minutes and 90 minutes, depending on the number of muscles requiring adjustment. Adjusting a single eye muscle may take 30 to 45 minutes. Procedures involving multiple muscles or both eyes will extend toward the longer end of the range. The surgeon accesses the muscles through a small incision in the conjunctiva, then weakens or strengthens them before closing the incision with dissolving sutures.
Total Time Commitment on Surgery Day
While the operation itself is relatively short, the total time commitment at the surgical facility typically ranges from three to five hours. This extended time begins with the check-in process and necessary paperwork. Pre-operative preparation involves meeting with the anesthesiologist, receiving intravenous access, and administering medications, which can take 30 to 60 minutes.
Following the procedure, the patient is transferred to the Post-Anesthesia Care Unit (PACU) for recovery. This is often the longest phase of the day, lasting one to two hours, as the medical team monitors recovery from general anesthesia and ensures vital signs are stable. Once the patient is fully awake and meets the discharge criteria, final instructions and prescriptions are provided before release. Patients utilizing adjustable sutures may require a longer stay for a post-operative alignment check.
Factors Influencing Surgical Duration
The length of the procedure is primarily determined by the complexity of the eye misalignment and the scope of the necessary muscle adjustments. The number of extraocular muscles the surgeon must operate on is the most significant variable affecting the operating room time. Adjusting two muscles will take less time than adjusting four muscles across both eyes.
Whether the surgery is a patient’s first procedure or a re-operation also impacts the duration. Previous surgeries can result in scar tissue or altered anatomy, making muscle identification and manipulation more time-consuming. The type of strabismus, such as a large-angle deviation or one with significant vertical components, may necessitate more intricate surgical steps, contributing to a longer time under anesthesia.
Post-Surgical Recovery Timeline
The patient’s return to normal life occurs in distinct phases following the procedure. The immediate post-operative period involves resting for the first 24 to 48 hours, during which mild discomfort and eye redness are common. Within two to three days, most individuals can resume light activities like reading and watching television, but they must avoid getting water in the eyes when showering.
Returning to school or non-strenuous desk work is generally possible within three to seven days, depending on the patient’s comfort and the extent of the procedure. Full recovery and the lifting of all activity restrictions typically occur over a four to eight-week period. Swimming and other water-based activities are restricted for at least four weeks to prevent infection while the dissolving sutures heal the incision.
Contact sports and activities involving heavy lifting or a risk of eye trauma should be avoided for six to eight weeks to protect the healing eye muscles. Follow-up appointments are scheduled to monitor the healing process, often starting the day after surgery, with subsequent visits over the next several months to assess final alignment. Although the eyes may appear straight shortly after the procedure, the muscles continue to adapt, and the final alignment stabilizes over several months.