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Strabismus Exotropia Surgery (Page 1)

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Hello, I have intermittent exotropia of my left eye. The deviation measures in the mid 20s for both near and far. It's a real pain, literally. My eye hurts almost constantly. I get double vision in certain gazes and my eye turns out and suppresses when I read. I get headaches, as well. This also causes me to be self conscious. I have to concentrate to keep my eyes aligned. I feel like it is breaking down into something more constant because of the amount of work I have to do to work around it. Tilting my head and straining my eyes to make the left one work properly.

So I am finally wanting to get this fixed. I've had it since I was four years old and have done nothing more than a few simple eye exercises here and there my whole life. I've been to a vision therapist recently. She never gave me anything concrete. After one session, I quit. So an orthoptist measured the angle of deviation and said I certainly could have it surgically corrected.

I am nervous. From what I read online about this surgery, I cannot help but feel this way. I do have 20/20 vision in both eyes and pretty good binocular vision. It just tends to be blinky in the distance because it becomes more difficult for me to use both eyes together in the distance without squinting.

Is there anybody else with intermittent exotropia? Is it a bad thing that I did not have this corrected when I was younger? Is the surgery successful in adults? I suppose I fear surgery making it more noticeable. Although it is a real nuisance, at least now I can hide this problem whether it mean tilting my head or squinting or whatever.

I just want to be rid of this self consciousness, double vision, suppression when I read, squinting and head tilting. I want to be able to use both eyes when I read a book. I guess another big fear of mine is losing something I already have. Like binocular vision.

I also have a question about if this will ever come back, if surgery is successful. I am afraid to battle my eye being aligned for the rest of my life. Maybe that's a silly worry? Is surgery a cure? No more deviation after surgery?

Is there anybody out there that is willing to discuss this with me?
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First Helper lwatters
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replied November 26th, 2008
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Hi Kelly,

Surgery may be required to realign the eye muscles if strengthening techniques are unsuccessful. Risks for any surgery include bleeding and infection. But other possible complications of a strabismus repair surgery include:

* Wound infections
* Damage to the eye (rare)
* Eye continues to be out of place

Adults are usually awake or sleepy, but pain-free during a strabismus surgery. Often, in adult surgery, an adjustable suture will be used so that minor adjustments can be made later that day or the next day. This technique usually gives a very good result. After surgery, the eye will be red for a couple of days. The corrected eye alignment is usually immediate.

I'd suggest that you research as much as possible before making your decision. A good place to start would be the National Libaries of Medicine:

http://www.nlm.nih.gov/medlineplus/eyedise ases.html

As an aside, you may want to look into the recent findings that link exotropia with mental illness in early adulthood. A study suggests that children with "exotropia type" strabismus may be at increased risk for developing mental illness by young adulthood. http://www.nlm.nih.gov/medlineplus/news/fu llstory_71152.html
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replied November 28th, 2008
Thanks for your response. I appreciate the information. Do you know much more about the surgery? My surgeon has said that he gives me a 95% chance that he can fix this completely with one surgery for the rest of my life. I hope he is correct. My deviation only comes and goes but it'd be nice to have it gone all together. That is why I'm looking into surgery. The biggest question I have about the surgery, I guess, is if it means I won't have any more deviation ever again. I just have read it's hard to completely eliminate. But my surgeon says he can. And my other concern is it coming back. But he says he doesn't think it will. So that is optimistic! Smile
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replied December 1st, 2008
Supporter
I think that it's a fairly low risk and good return. No surgery can be 100% predictable, but I think that your odds of correction are pretty good. My sister has the surgery performed when she was 6 years old, and a recent colleague at 28 years old. You'll ultimately have to make the decision yourself. Keep asking questions until you're ready.
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Users who thank rooted for this post: lachickee 

replied December 1st, 2008
Thanks again. Is surgery a cure? Does it make the turn go away completely? Does your sister's eye/eyes ever turn now since surgery?
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replied December 3rd, 2008
Supporter
Yes, the surgery aligned her eye permanently.
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replied January 25th, 2009
@ lachickee

so did u went with the surgery? i have the same problem and same confusion lolz so need to know wat have u done abt it ?
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replied January 25th, 2009
I have not yet had the surgery. I will be seeing my ophthalmologist again in a few weeks so that I can ask him all of my questions. So your eye drifts out the way mine does? How is your vision?
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replied January 26th, 2009
i have intermittent exotropia. Initially in my childhood it was very rarely seen but during my teen age days it became very very prominent but now with some exercises and concentration it again very rarely seen my vision is perfect no issues regarding that just faces a little difficult in socializing still i do it alot (real problems were faced when i was doing A levels) anywayz r u on facebuk u can c me there my profile is

Cheers
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replied April 6th, 2009
good surgeon
Could somebody refer a really good surgeon for intermittent strabismus on the east coast. I would appreciate it.
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replied June 7th, 2012
Dr. Joeseph Napolitano, M.D.
Omni Eye Services
Four NJ locations
732-750-0400
973-538-7400
973-325-6734
201-368-2444
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replied June 7th, 2012
Dr. Joeseph Napolitano, M.D.
Omni Eye Services
Four NJ locations
732-750-0400
973-538-7400
973-325-6734
201-368-2444
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replied April 6th, 2009
Surgery
I just had the surgery done on Friday. I went to see Dr. Dereck Hess in St. Petersburg FL. I have had 5 surgerys now since I was 7yrs old. I am now 27. They told me that I should grow out of it by adulthood but I did not. This last surgery was done because it was found that my migraines (2 a week) were being triggered from my exotropia. My brain has learned to "turn off" my left eye in order to not see double when I get tired. I do not regret getting the surgerys. And would definately recommend Dr. Hess to anyone. I have heard tht in some cases the surgery is a permanent fix but in my case it was not. As I grew and time went by the muscles got weaker and needed to be adjusted. Hope this helps.
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replied April 6th, 2009
cost
Hey Liz Thanks for the info. Just wanted to ask how much the surgery costs and does insurance cover it?
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replied April 25th, 2009
Strabismus Exotropia
I wrote about my own experience on another post which I will paste again below. I want to say too that everyone's experience is different and I'm not an expert here. I have read that most people with strabismus will need two to three surgeries during their lifetime. I've also read/heard that surgery often only fixes the problem cosmetically but not the underlying problem which is why you need more surgeries as your eyes go back to working the way they also have (the way your brain is wired.) Also that most mainstream doctors will suggest surgery even though this doesn't solve the underlying problem My doctor (see below) thinks that my early surgeries did more harm that good, causing my eyes to go from Esotropia (crossed eyes) to Exotropia - overcorrection - although these surgeries did take place more than 30 years ago and I would hope they're better done now. I am sure that each case is different and it probably depends on how severe your exotropia is and how long you've lived with it. Lachikee, it doesn't sound like the vision therapist you went to was very helpful! I would encourage you to try vision therapy again with someone more knowledgeable.

"Hi, I'm 44 years old and am finally correcting my strabismus. I had two operations (one at 4, another at 7) and while it fixed my eyes cosmetically (until several years ago when my right eye started to roam again) it didn't fix the fact that I was only using one eye when I focused on anything (my brain had learned to shut down my right eye as a child so that I wouldn't see double.) Basically when your eyes aren't pointed in the same direction your eyes aren't seeing the same image and so your brain learns how to just use one eye which of course encourages the other eye to get lazier. I started Vision Therapy with a doctor in Charlotte last October (driving two hours each way) and now not only have I learned how to switch both eyes on at the same time but bring the two separate images I see together so that they become one (I can do this pretty easily now close up, automatically and am getting better and better with longer distances; still working on depth/3D perception.) The most exciting thing is not that my eye look fine most of the time now cosmetically but that my brain at the age off 44 has learned how to use my eyes correctly again! Yes, it's been a big commitment financially and time-wise but well worth it! And it's not just about the eyes; my doctor who mostly works with children believes there is usually an emotional component as well and that being able to use both eyes helps with all kinds of things like decision making and trusting the world (after all if you can't trust what you see!) I encourage everyone with strabismus to embark on this amazing journey."
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Users who thank lwatters for this post: grace17 

User Profile
replied May 1st, 2009
"Lazy Eye" surgery
I am 37 and my right eye has always turned out. I am very self concious about it. I recently changed my eye doc and he suggested muscle surgery to correct this problem. I am very interested but I am a little scared about it. Does anyone have any advice or know anyone that has had this procedure done?? Please write me.

Any information will be greatly appreciated.
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replied October 20th, 2009
I am 33 and I have had Exotropia all of my life. I am finally scheduled to for surgery on November 6th. Im really excited about it.
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replied November 1st, 2009
Strabismus
Im 17 and I have had this problem every since I was born. its a real nuisance. I have had 3 corrective surgeries all to no avail. I may try one more and see if it helps.
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replied July 7th, 2010
Estropia coming back after surgery
I had surgery 16 years ago and my eye would only wander when I was really sleepy. Now it is becomming worse and it beginning to wander more often. I am not sure how to fix it or what to do?
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replied March 22nd, 2011
You may require follow-up surgery, unfortunately, but I'd first get a consultation about HTS home vision therapy. That may correct the problem, or may delay having to go through surgery again. I've had similar problems, and trust me, it won't go away, it'll only occur more often as time goes on unless you either find home vision therapy helpful, or have another surgery. The muscles involved in correcting this are very tiny, so the fewer times you have the surgery, the better, due to possible problems with scarring after repeated surgeries. Good luck!
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replied April 23rd, 2012
Syptoms, and outcomes Extropia
I wondered if surgery recovery was easy for anyone. I also have had this problem for the last 5 years, I am 50 years old. They said it came on from a trauma I had. I have headaches probably 4 times a week had to quit my job which was working with numbers as it caused to much strain. Very sensitive to light so I wear sunglasses as much as possible. Has anyone else had the same issues, driving at night I am unable to do anymore. It seems that my life has been turned upside down. I do get depressed from the headaches as well as the fact I cannot see as well anymore. I am scheduled for surgery in a few weeks. Just wondered if anyone has had the same symptoms. Thank You
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replied April 23rd, 2012
Syptoms, and outcomes Extropia
I wondered if surgery recovery was easy for anyone. I also have had this problem for the last 5 years, I am 50 years old. They said it came on from a trauma I had. I have headaches probably 4 times a week had to quit my job which was working with numbers as it caused to much strain. Very sensitive to light so I wear sunglasses as much as possible. Has anyone else had the same issues, driving at night I am unable to do anymore. It seems that my life has been turned upside down. I do get depressed from the headaches as well as the fact I cannot see as well anymore. I am scheduled for surgery in a few weeks. Just wondered if anyone has had the same symptoms. Thank You
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replied June 20th, 2012
Hi Brysa, wondering how your durgery truned out, Having the same problem with intermitent double vision, Dr has sugested muscle surgery, but not totally convinced that this is the right decision. Am seeking second and even third opinion, Can anyone recommend a Dr in the Midwest/Saint Louis, MO area?
thanks
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replied June 26th, 2012
Strambismus surgery 4 days into recovery
I just got my strambismus surgery 6 days ago.. I am as now a bit dissapointed with my outcome. I have intermittent exotropia on both eyes, but it is a lot worse on my left eye. In which in this case he did the surgery on my left eye. If you would normally see me you would never think I had wondering eyes because I am constantly straining my eyes to keep them straight. It's been about 3 years where my left eye has started to turn out especially when tired or stressed. It got to the point where driving got very scary because I couldn't focus on the road in front of me. I am now still using my right eye when I see, mainly because I think my brain has learned to turn off my left eye because it is the weakest eye. After the surgery my eye still turns out when relaxed. Hence, the dissapointment from surgery. I have an appointment tomorrow for my 1 week evaluation at which point I will describe to my doctor my concern and dissapointment from my eye. For those who are wondering if it hurts; the procedure itself does not hurt. All I remember was falling asleep and waking up in the recovery room. Nothing else. So please don't be afraid if you think you will feel something during surgery. I didn't. Again, I was under general anesthesia. Some doctors do adjustable sutures in which I believe you are under local anesthesia. You will go home with a patch in which will be removed the next day. You will have some pain ( not agonizing) but bothersome. Tylenol or Advil should alleviate it. You will be prescribed some antibiotics/ antiinflammitory drops in which you will put in your eyes about 4 x a day depending on your doctor's orders. During my recovery now, my eye is swollen. It stings, feels scratchy as if I had a bunch of eyelashes in it. I found that lubricant drops inserted in the eye 5 minutes after antibiotics were inserted helped. I use the gel ones at night as well. It hurts when I move it around since the muscles are still tight from the sutures. Realistically looking at my recovery time it looks like it will take about 3 months for my eye to completely heal. Will I have surgery done on me again? No. I have my son who is 2 and relies a lot on me. I will probably try vision therapy and see if it helps; depending on how my eye is after the six weeks which from what I've been reading is when we can really see the true outcome of the surgery. Hope this helps. Again, remember every case is different.
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