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106 - Eye muscle surgery

Published online by Cambridge University Press:  12 January 2010

Michael F. Lubin
Affiliation:
Emory University, Atlanta
Robert B. Smith
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Nathan O. Spell
Affiliation:
Emory University, Atlanta
H. Kenneth Walker
Affiliation:
Emory University, Atlanta
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Summary

Eye muscle surgery is performed to correct strabismus, which is any horizontal, vertical, or torsional misalignment of the eyes that affects both children and adults. The disease can be congenital, acquired, restrictive, or paralytic. The purpose of surgery is to restore the eyes to their normal, anatomical position; to maximize the potential for binocularity; and, in some cases, to eliminate diplopia. Either one or multiple muscles may be involved in the operation and bilateral procedures are common. In cooperative children and adults, a postoperative adjustment of the muscle position may be performed once the effects of anesthesia have dissipated.

Strabismus surgery is most often performed under general anesthesia, though local anesthesia and even topical anesthesia can be used in adults.

Usual postoperative course

Expected postoperative hospital stay

Most strabismus surgery is performed on an outpatient basis. Hospitalization is unusual.

Operative mortality

Related to anesthesia. The incidence of malignant hyperthermia may be slightly higher in strabismus patients than in the general population.

Special monitoring required

None necessary.

Patient activity and positioning

For 2 weeks, patients are advised to avoid swimming and other activities that may introduce contaminated material into their eyes. Young children should be properly supervised and discouraged from rubbing their eyes. Dressings are usually unnecessary.

Alimentation

Oral intake should be resumed gradually, since nausea and vomiting are common after strabismus surgery, especially in children.

Antibiotic coverage

Topical antibiotic or antibiotic/steroid combination drops may be used optionally.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
, pp. 708 - 709
Publisher: Cambridge University Press
Print publication year: 2006

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References

Mills, M. R. & Fricker, S. J. (2000). Surgical management of strabismus. In Albert, D. M. & Jakobiec, F. A., eds. Principles and Practice of Ophthalmology, 2nd edn. Philadelphia, PA: W. B. Saunders, vol., 2000: 4379–4393.Google Scholar

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