Eye muscle repair is surgery to correct eye muscle problems that cause crossed eyes. The medical term for crossed eyes is strabismus.

The goal of this surgery is to allow the eye muscles to be in proper position and help the eyes move correctly.

Eye muscle repair surgery is usually done on children, but adults who have similar eye problems may also have it done. Children will usually receive general anesthesia for the procedure. They will be asleep and will not feel pain.

After the anesthesia has taken effect, an eye surgeon makes a small incision (cut) in the tissue between the eye and eyelid. This tissue is called the conjunctiva. Then the surgeon will locate 1 or more of the eye muscles that needs repairing. Sometimes the repair strengthens the muscle, and sometimes it weakens it. To strengthen these muscles, a section of the muscle or tendon may be removed. To weaken these muscles, a suture (stitch) may be made to change the position of the muscle.

The surgery for adults is similar. Most adults are usually awake and sleepy, but pain-free. Numbing medicine injected around their eye will block pain. Often in adult surgery, an adjustable suture will be used so that minor corrections can be made later that day or the next day. This technique usually has a very good outcome.

Surgery may be recommended when strabismus does not improve with medicine or glasses.

Risks for any anesthesia are:

• Reactions to anesthesia medicines
• Breathing problems

Risks for any surgery are:

• Bleeding
• Infection

Some other possible complications are:

• Wound infections.
• Damage to the eye. This is rare.
• The surgery does not correct the problem and the eye is still out of place.
• Permanent double vision. This is rare.

Your child’s eye surgeon may ask for:

• A complete medical history and physical exam of your child before the procedure
• Orthoptic measurements (eye movement measurements)

Always tell your child’s doctor or nurse:

• What drugs your child is taking.
• Include any drugs, herbs, or vitamins you bought without a prescription.
• Tell them about any allergies your child may have to any medicines, latex, tape, or soaps or skin cleaners.

During the days before the surgery:

• About 10 days before the surgery, you may be asked to stop giving your child aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for blood to clot.
• Ask your child’s doctor which drugs your child should still take on the day of the surgery.

On the day of the surgery:

• Your child will usually be asked not to drink or eat anything for several hours before the surgery.
• Give your child any drugs your doctor told you to give your child with a small sip of water.
• Your child’s doctor or nurse will tell you when to arrive for the surgery.
• The doctor will make sure your child is healthy enough for surgery and does not have any signs of illness. If they are ill, the surgery may be delayed.

This surgery is usually done on an outpatient basis. The corrected eye is usually straight right after surgery.

Your child will be kept from rubbing their eye until they have recovered from anesthesia. Eye rubbing later on is not a problem, since children close their eyes when they rub them.

After a few hours of recovery, the child may go home. You should have a follow-up appointment with the eye surgeon 1 to 2 weeks after the surgery.

Eye muscle repair surgery does not fix the poor vision of a lazy eye, so a child may have to wear glasses. In general, the younger a child is when the operation is performed, the better the result. Your child’s eye should look normal a few weeks after the surgery.

Lingua RW, Diamond LG. Techniques of strabismus surgery. In: Yanoff M, Duker JS, Augsburger JJ, et al, eds. Ophthalmology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004:chap 81.

Olitsky SE, Hug D, Smith LP. Disorders of Eye Movement and Alignment. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 622.