Strabismus Surgery 

Eye showing muscle moved. Eye showing muscle cut.

The eye doctor may recommend strabismus surgery to help align your child’s eyes. During surgery, certain eye muscles are adjusted. This helps the muscles better control how the eye moves. Often, surgery is done in addition to other treatments. In most cases, children who have strabismus surgery go home the same day.

How surgery works

Strabismus surgery is a safe, common procedure. The eye doctor simply changes the placement or length of an eye muscle. This small change can pull the eye into proper alignment. The 2 most common methods of surgery are:

  • Recession. A muscle is moved to a new position on the eye.

  • Resection. Part of an eye muscle is removed then reattached to the eye at the original place.

Before surgery

Prepare your child for the procedure as you have been instructed. In addition:

  • A few days before surgery, your child may have an eye exam so the doctor can double-check eye measurements.

  • Follow any directions your child is given for taking medicines and for not eating or drinking before surgery.

On the day of surgery, your child:

  • Can wear favorite pajamas and bring along a toy.

  • Will be given medicine (anesthesia) that makes him or her sleepy. Surgery won’t start until your child is asleep.

After surgery

Each child reacts to surgery in his or her own way. Some children may be afraid to open their eyes at first. Children are often sleepy or cranky for several hours after surgery. If your child’s response worries you, talk to the eye doctor. After surgery your child:

  • May have a red eye. This will go away after several weeks.

  • Will most likely not need any pain medicine. Recovering from strabismus surgery is not painful for most children.

  • May still need other treatment, such as glasses or an eye patch.

When to call the healthcare provider

Call your child’s eye doctor if:

  • Your child’s eyelid is very swollen.

  • A pus-like discharge comes from the eye. (A few bloody tears are normal.)

  • Your child vomits more than once.

  • Your child has a fever (see Fever and children, below).

Risks and possible complications

As with any surgery, strabismus surgery has risks. These include:

  • The eyes not being perfectly aligned. Some children need more surgery to adjust this.

  • Bleeding in or around the eye

  • Eye infection

  • Risks of anesthesia (the eye doctor can tell you more about these)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

Below are guidelines to know if your child has a fever. Your child’s healthcare provider may give you different numbers for your child.

A baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

A child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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