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Children Squint Surgery

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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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