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CHILDREN’S SQUINT SURGERY Information for parents Ophthalmology Department Produced: March 2010 Review date: March 2013 What is a Squint? A Squint (Strabismus) is a misalignment of the eyes so they do not look together towards the same object. An eye may turn in (convergent squint) or turn out (divergent squint). Occasionally one eye may be higher or lower than the other (vertical squint). The squint may be there all the time (constant squint) or only some of the time (intermittent squint). What does the operation involve? Your child will have a general anaesthetic. For further information please see separate anaesthetic leaflet. Surgery to correct a squint involves moving muscles attached to the surface of the eye to a new position. Six external muscles are attached to each eye but usually only one or two of these muscles are operated on. Generally it is the squinting eye that is operated on but it may be necessary to operate on the other eye to give better results by balancing the eyes. The eye is not removed during surgery. What are the expected benefits of treatment? Surgery is expected to improve cosmetic appearance of the squint by reducing the angle and may also enable the eyes to work together better, which helps 3D vision (the binocular function). In some cases surgery may relieve double vision. What are the alternatives? Surgery will only be suggested when there are no applicable alternatives. In a few cases botulinum toxin injections may help a squint but its effects are short term and it is rarely appropriate for the long term management of squints in children. What happens before admission? Your child’s admission will be planned as a day-case. This means your child will usually have the operation and go home the same day, but may need to stay overnight You will receive a phone call to check that the planned admission date is convenient This will be followed by a letter confirming the date and giving further details about the admission A separate letter will be sent to you with a date for your child to attend for a pre-operative orthoptic assessment. This will usually be arranged during the final fortnight before the admission date Please let the orthoptist know if you have to cancel as failure to attend may mean your child’s operation has to be cancelled If your child wears glasses please bring them to the pre-operative orthoptic assessment. A visit to the children’s ward prior to admission is highly recommended and is usually arranged to follow on from the pre-operative orthoptic assessment. This can help alleviate anxiety for you and your child and familiarise yourself with the location and facilities What happens after the operation? The eye may be red, gritty and a little sore and your child may experience some blurred vision. The skin around the eye is not affected. Your child may have an eye patch over the eye and this is left on for as long as your child tolerates it. It will stop your child rubbing the eye and it will soak up any blood- stained tears. The patch will be removed before your child is discharged. Out-patient appointments will be given to you for your child to see the orthoptist and the doctor. What should I do when my child goes home? Your child will be given eye drops to take home and you should use these as instructed Discourage rubbing or touching the eye The redness of the eye can last up to four weeks Give your child painkillers as required Wash the face as usual. If the eye(s) are a little sticky use cotton wool, soaked in cooled boiled water. Clean from the nose outwards using each cotton wool pad only once Use a mild baby shampoo for hair washing Your child should stay off school for at least a week, but otherwise, can return to normal daily activities avoiding dusty and sandy environments for two weeks, contact sports for four weeks and swimming for four to six weeks Your child should continue to wear glasses as normal unless advised by an orthoptist or doctor Will we have to come back to hospital? An appointment will be made for your child to return to the eye clinic to see a doctor and an orthoptist soon after your surgery. What are the potential risks and side effects? Squint surgery is very safe and complications are rare A general anaesthetic is required, which carries some risk. Further information can be found in Anaesthetics information leaflets Your child may experience nausea following surgery but medication can be given to relieve this In the operated eye, bleeding and infection can occur and during surgery, perforation of the eye and retinal damage can occur. Both of these are extremely rare There may be an under or over-correction of the squint and further surgery may be advised. It may not be possible to achieve perfect alignment Your child may get some double vision but this is often temporary Scarring can occur at the surgery site although this is usually not noticeable after some months Repeat squint surgery carries a slightly higher risk of noticeable scarring Although you will sign a consent form for this treatment, you may at any time after that withdraw such consent. Please discuss this with your medical team. Other sources of information If you experience any problems following your operation please contact: Royal Preston Hospital children’s ward (Ward 5) 01772 522245 Royal Preston Hospital Orthoptic department 01772 522417 Other formats If you require this leaflet in any other format such as larger print, audio tape, Braille or an alternative language, please ask at one of our PALs offices. If you require interpreting services during your hospital visit please ask a member of staff who will be able to organise this for you via the appropriate department. After reading this information are there any questions you would like to ask? Please ask the orthoptist or your surgeon Sources of further information: www.lancsteachinghospitals.nhs.uk www.nhsdirect.nhs.uk www.patient.co.uk Lancashire Teaching Hospitals NHS Foundation Trust is not responsible for the content of external internet sites.
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