Normally, the eyes work as a team, aiming at the same spot, providing the brain with the information it needs to create a three dimensional image. This three dimensional image is what gives a person the depth perception which helps us in so many daily activities in work, play and sports. Strabismus means that the two eyes point at different spots (that is in different directions) and the brain sees two different images which cannot be combined, or fused, into a single image. In young children the brain will then ignore or turn off the image in one eye or the other to prevent confusing double vision. Older people with a new strabismus may be unable to ignore (or suppress) an image and will see double.
Almost half of the strabismus we see at the Spokane Eye Clinic can be treated with glasses, prisms, exercises and patching. It is important to line the eyes up as early as possible so that the brain can develop the best ability to combine or fuse the images of the two eyes into one picture. So if these techniques are not effective surgery will usually be recommended.
Modern strabismus surgery is done in an outpatient setting and is minimally invasive. The Ophthalmologist makes a small incision in the tissue covering the white of the eye to reach the eye muscles. Each human eye has six muscles, responsible for moving it in various directions, and typically the surgeon repositions one or more of these muscles, in one or both eyes, to bring the eyes into alignment. Once aligned, the eyes can move together as intended, sending images back to the brain which may be fused into one three dimensional image. This is done in the safety of an operating room with general anesthesia providing complete comfort to the patient.
Recovery time is rapid. Most normal activities can be resumed within a few days. After surgery glasses, sometimes with prisms, and sometimes exercises or patching may be helpful "fine tune" alignment. Further surgery at a later time is often needed to keep the eyes in good alignment.
As with any surgery, eye muscle surgery has some risks. These include infection, bleeding, excessive scarring, and very rare cases of vision damaging complications. Usually strabismus surgery is safe and effective.
Torticollis is a persistent tipping and or turning of the head, and when it is done to prevent double vision or blurring it is called ocular torticollis. The two most common causes are nystagmus, which is a rhythmic back and forth eye jerking, and some forms of strabismus where the alignment if the eyes is better in some directions or head positions. Modern eye muscle surgery can reduce nystagmus and improve head position in many cases. Similarly, with careful diagnostic measurments of all of the eye muscles, the ophthalmologist can design strabismus surgery to improve the imbalances between muscles, so that the head tilt or turn is no longer necessary to achieve single vision. As with any eye muscle surgery it is outpatient with rapid recovery being usual. Glasses, often with small amount of prism may enhance the results of surgery.