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"What is strabismus surgery?"
I have a 6-year-old daughter, and our doctor is concerned with her misaligned eyes. She thinks we should have strabismus surgery to correct the alignment, but this is intimidating to me. Is surgery really necessary? If we do it, what are the potential risks? What is the cost-benefit judgment here?
The evaluation of strabismus should involve the care of specialists including pediatricians, ophthalmologists, and others. Strabismus is the term to describe ocular misalignment. It can occur in one eye, both eyes, and in any direction. This is relatively common and occurs in 2-4% of the population. Risk factors include a positive family history of strabismus and low birth weight. Pseudostrabismus, or intermittent ocular instability of infancy, should be ruled out first. It is important to differentiate between congenital (from birth) and acquired strabismus because some types of acquired strabismus can be life-threatening or vision-threatening (such as retinoblastoma, cranial nerve problems, cerebral trauma, Grave's disease, myasthenia gravis. There are both medical and surgical treatments to help with vision. Certain prescription sunglasses and optic prisms may help with vision. Surgery typically involves resection and repositioning of certain muscles that help with movement and alignment of the eye without typically affecting the eye itself. Of course, any surgery involving the eye puts the patient at risk for visual problems and alterations in the nerves and tear ducts but also infection, inflammation, and pain. The decision for medical and surgical therapy is complicated and includes severity and underlying causes. It is not possible to develop a diagnosis or management problem without seeing the patient. It is therefore the strong recommendation is to continue to work with your ophthalmologists regarding both conservative and invasive options as well as ensure other more serious causes of strabismus have been evaluated.
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