Strabismus, commonly referred to as crossed eyes, is a condition where the eyes do not align simultaneously when focusing on an object, turning inward, outward, upward, or downward. This misalignment occurs because of an imbalance in the six extraocular muscles surrounding each eye, which control eye movement. Strabismus surgery aims to correct this by adjusting the tension or position of these muscles, thereby restoring proper eye alignment.
Preparation and Anesthesia Time
The process on the day of surgery begins well before the operation itself, often requiring the patient to arrive at the surgical center one to three hours prior to the scheduled procedure. This initial window is dedicated to administrative check-in, vital sign measurements, and patient preparation. A significant portion of this time involves the pre-anesthesia consultation, where the anesthesiologist reviews the patient’s medical history and answers any final questions.
The patient will have an intravenous (IV) line placed to administer fluids and medication. For most children and many adults, the procedure is performed under general anesthesia, meaning they will be completely asleep. The time required for the general anesthesia to be administered and take full effect, known as induction, is part of this pre-operative phase. Overall, this preparation period, from check-in to the start of the incision, typically constitutes the longest block of time spent at the facility, sometimes taking an hour or two.
The Operating Room Procedure Length
The duration of the strabismus surgery focuses solely on the time the surgeon is actively adjusting the eye muscles. The procedure involves making a small incision in the conjunctiva to access the underlying muscles. The surgeon then either shortens the muscle (resection or plication) to tighten it or moves its attachment point further back (recession) to weaken its pull, using dissolvable sutures to secure the muscle in its new position.
The total length of the operation is heavily influenced by the extent of the correction required, specifically the number of muscles being adjusted. The procedure usually takes approximately 30 minutes for each muscle being operated on. Therefore, a relatively straightforward case involving one or two muscles might take between 30 and 60 minutes. More complex corrections involving muscles in both eyes could extend the operating time toward two hours.
Recovery Room Stay and Discharge
Immediately following the procedure, the patient is moved to the Post-Anesthesia Care Unit (PACU) to wake up from the general anesthesia. The primary focus in the PACU is continuous monitoring of vital signs, including heart rate, blood pressure, and breathing, to ensure a smooth emergence. Nurses also manage initial post-operative symptoms, such as pain, nausea, and the common feeling of grittiness or soreness in the eye.
The patient’s stay in the recovery room is typically an outpatient process, usually lasting between one and three hours, meaning no overnight hospital stay is required. Discharge is dependent on the patient being fully awake, stable, and able to tolerate fluids. A responsible adult must be present to drive them home and stay with them. Before leaving, the patient or accompanying adult receives detailed instructions on medication, eye drops, and what to expect at home.
Short-Term Healing and Follow-Up
The short-term healing phase begins immediately upon discharge, with most patients able to return to non-strenuous activities, like school or work, within one to three days. The eyes will commonly appear red due to a subconjunctival hemorrhage—a bright bruise under the clear membrane—which can take several weeks or even a few months to fully resolve. Mild discomfort, soreness, and slight swelling typically subside within the first few days to a week.
The follow-up appointment is typically scheduled within the first week after surgery to assess the initial healing and eye alignment. Patients are advised to avoid swimming for at least two weeks and refrain from contact sports or heavy lifting for a similar period to protect the delicate surgical area. Although initial alignment may be visible, the final, stable outcome of the surgery may not be fully apparent for several weeks or even months as the muscles and the brain adapt to the new eye position.