Squint surgery for children and adults
Information for patients and parents from the Orthoptic Department
You or your child have been referred to the hospital for squint surgery. This leaflet will:
explain what squint surgery is
what happens at your pre-assessment appointment, and
how to look after your eye once you return home.
If you have any questions after reading this leaflet, please speak to your ophthalmic surgeon / orthoptist before your operation.
We want to hear your views on the information that we provide, so please let us know if you feel we should have included any additional information.
What is squint surgery?
Squint surgery involves adjusting the position of the eyes. This is done by moving the muscles on the outside of the eyeball. Two muscles are usually adjusted. This may be in one or both eyes, but occasionally just one or more muscles will give the best result. This surgery does not involve removing the eye.
You may need surgery to:
make your eyes appear straighter; or
to allow your eyes to be used as a pair.
Your orthoptist and / or ophthalmologist (eye doctor) will discuss this with you. You should be clear about your expected outcome.
Are there risks to having this surgery?
Your surgeon will discuss the risks of surgery with you at your pre-assessment appointment, before you give consent for treatment.
Why do I need to sign a consent form?
All patients must give permission before they receive any type of medical treatment, test, or examination. Consent is usually given when you sign the consent form before your treatment, but we may ask you to give it verbally.
You must give your consent voluntarily.
The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent. If you have not been given this information, or you have but you still have questions, please speak to a member of staff.
You must be capable of giving consent. This means that you understand the information given to you and can make an informed decision.
When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.
What are the benefits / alternatives to having surgery?
The benefits or alternatives will depend on your type of squint. Please discuss these with your orthoptist / ophthalmologist at any stage.
What will happen at my pre-assessment appointment?
Your orthoptist will repeat all the measurements and discuss these with your consultant.
You will see the consultant ophthalmologist who will explain the procedure to you. Use this time to discuss any worries or concerns that you may have. Remember you can withdraw your consent for treatment at any time.
Where possible you will also visit the Ophthalmology Suite or children’s ward on this day.
You will be given a date to return to see the orthoptist within one to two weeks of your operation.
You will not see your consultant on this visit, but a doctor will be available if needed.
The nurses on the Ophthalmology Suite or children’s ward will explain what will happen when you come into hospital on the day of your operation. Please ask any questions you have about yours or your child’s care on the day of surgery.
What will happen when I arrive at the hospital?
Your appointment letter will tell you when and where you should report to on the day of your surgery.
A member of nursing staff will meet you and explain the procedure for the day. You will also meet the anaesthetist.
Will I need a general anaesthetic?
Squint surgery is performed under general anaesthetic - you / your child will be asleep for the operation. The anaesthetist will visit you in the day case unit on the day of the operation.
General anaesthetics cannot be given to patients that are unwell. Please tell the unit if you are or your child is ill.
What if I have an adjustable suture procedure?
Some adult patients (over the age of 15 years) may have an adjustable suture procedure. With this procedure, the main part of the operation is performed under general anaesthesia but the stitches are not completely fixed.
Later in the day the orthoptist will take further measurements of the angle of squint. Then, using local anaesthetic eye drops to numb your eye, your surgeon will make minor adjustments, as needed. This will make sure you have the best possible results from your operation.
How long does the operation last?
Usually surgery lasts about 60 to 80 minutes. This will depend on how many muscles are being operated on and whether your operation involves both eyes.
When will I be discharged from hospital?
Adults remain in the Ophthalmology Suite until it is time to go home, which is usually by 6pm that day.
Do not drive yourself home after your procedure. Arrange for someone to drive you to and from the hospital. You can start driving after a day or so, when you are comfortable and can see without double or blurred vision. Please speak to your orthoptist if you are unsure about driving.Children are transferred to the children’s ward following recovery. If all is well, they will go home later that day. Rarely a child may need to have an overnight stay in hospital. If so, parents are welcome to stay with their child.
After their operation, your child may vomit. This can be due to the surgery or the anaesthetic. Do not worry. If this continues for longer than 12 hours, contact your GP or telephone the children’s ward for advice.
How should I look after my eye(s) at home?
Eye pad
Children are not usually given eye pads following squint surgery. Adults may be given an eye pad that they can remove the day after surgery.
Eye drops
Eye drops will need to be instilled four times a day, for two weeks following surgery. The nurses on the ward will show you how to do this before you leave hospital. These drops will prevent infection and help your eye to heal more quickly. They may sting on instillation, but this quickly settles.
Redness and stitches
Your eye will remain red for several weeks after surgery. The stitches used are dissolvable and do not need to be removed. You may see them as white or blue bits on the white of your eye. These can feel quite itchy for one to two weeks after your operation.
To begin with your eye may be sticky, especially when you wake up; the antibiotic drops will help this. Use cooled boiled water and a moistened cotton wool bud to remove stubborn dried discharge from your eye.
Pain
If you have any pain after surgery, take your usual pain relief. This can be paracetamol for adults or Calpol for children. This is especially important for adults undergoing adjustable stitches once the numbing effect of the drops wears off. The pain should calm down within 24 hours. If it continues contact the Orthoptic Department, children’s ward, or your GP.
Occlusion patch
If your child normally wears a patch to help improve their vision, they should not wear this for the first week after their operation. They can use the patch again after speaking to the orthoptist at their follow-up appointment.
Glasses
Continue wearing the glasses you wore before your operation, unless told otherwise by your ophthalmologist or orthoptist.
Time off work or school
Usually you will need one to two weeks off work or school. This is mainly due to the effects of the general anaesthetic. The redness of your eye does not prevent you working or going to school. Your vision (although slightly blurry at first) is unaffected.
When can I resume my normal activities?
Due to the risk of infection, wait a month or more before you can start swimming again.
You can begin other non contact sports as soon as you have recovered from the anaesthetic.
You must not take part in any contact sports for at least a month following surgery.
To avoid infection, take care when washing your hair.
Avoid rubbing your eye after your operation.
Will I have follow-up appointments?
Yes. After your one week follow-up appointment, your appointments will generally be at one month and three months. The severe redness has usually gone by one month. After three months the eye generally looks normal. The best results are seen three months following surgery.
Will further surgery be needed?
Your expected outcomes will have been discussed with you when you were listed for surgery and again at your pre-assessment appointment. If during the first week after your surgery your outcome is not as you expected, please contact the Orthoptic Department on 01227 868615. Please remember though, that it may not be until your first or second follow-up appointment that you see the outcome you expected.
Some squints need more than one operation. This may be a planned second procedure or decided upon at a later stage.
How long will I be monitored after surgery?
Patients may be discharged within one year of their surgery, if their outcome is satisfactory to all concerned.
Contact details
Dolphin Ward, Kent and Canterbury Hospital, Canterbury
Telephone: 01227 864052Orthoptic Department, Kent and Canterbury Hospital, Canterbury
Telephone: 01227 868615