You may remember about a year ago, we started treatment for Bella's
Strabismus-Intermittent Extropia of her left eye (basically one eye drifts off).
The Plan was to patch both eyes alternating each one, left for 3 hours one day and then the right eye 3 hours for two days, then left one day and so on.
In the next few days we will hear from the Dr when Bella will have her surgery.
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
The surgical procedure for children with Exotropic (outward) Strabismus involves a weakening of the outside (lateral rectus) muscles. In some instances, this recession may need to be complemented with a resection of the inside (media rectus) muscles. For children with Strabismus and who have not developed Amblyopia, surgery is typically necessitated. It is expected that with age, a child will benefit from improved depth perception. The typical surgery for Esotropic Strabismus is muscle recession of the inner eye. Surgery may be required for one or both eyes. In some instances, the recession is complemented by a resection of the muscles of the outer eye. The typical surgical procedure for Hypertropic Strabismus involves a weakening of the deviated muscle and a repositioning of other muscles on the eye.
The level of success or complications from Strabismus surgery varies from individual to individual. The most severe complications may include retinal detachment or Endophthalmitis, which is inflammation of the eyeball. These complications are rare and result from an accidental perforation of the eye globe during surgery. Other complications that are typical for any surgical procedure, such as infection, bleeding and scarring may also result. Some discomfort may be experienced from the sensation of foreign bodies in the eye. Strabismus surgery is usually performed as an outpatient procedure, but patients in poor health may require hospitalization. Recovery is typically within days of the surgery.
From another web site:
Understanding Strabismus Surgery
To understand how strabismus surgery works, consider that each of your eyes has six outside (extraocular) muscles controlling eye movements.
If a muscle is too strong when you have strabismus, it may cause the eye to turn in, turn out or rotate too high or low.
On the other hand, an eye muscle weakness in certain cases may also cause misalignment. This condition may occur if you have a cranial nerve dysfunction affecting how eye muscles control movement.
Fortunately, your ophthalmologist has various surgical options to help correct these types of problems.
Strabismus Surgery Involving Recession and Resection Procedures
In a recession procedure, your eye surgeon detaches the affected outside muscle (extraocular muscle) from the eye and reattaches it (resection) farther back on the eye to weaken the relative strength of the muscle if it is too strong.
In contrast, if the muscle is too weak, your surgeon may use a recession procedure to reduce strength of the opposing muscle (antagonist) to achieve more balanced function of the eye muscles.
In certain cases, a resection procedure may be used to strengthen an eye muscle to correct misalignment associated with strabismus. If you have inwardly turned eyes (esotropia), the surgeon may strengthen the lateral rectus muscles — located on the side of each eye, toward the ear — by reattaching the muscle in a different location (resection). In this way, the lateral rectus muscles are relatively strengthened and they can turn the eyes farther outward. This results in better eye alignment.
What To Expect After Strabismus Surgery
Your eyes will be red and somewhat sore after strabismus surgery. You probably will see obvious bright red blood in the surgical area, usually toward the inside or outside corner of the eye. This is normal and is equivalent to bruising of your skin.
Eye redness should fade within two to three weeks. You may feel like something is in your eye, but this sensation will subside. Usually you can resume normal activities within a few days.
During the first few days after surgery, eye alignment is a good indicator of the final outcome. However, more permanent results may not be known until four to six weeks after surgery.
Children younger than 10 will very likely need a second or third strabismus procedure to maintain the best possible eye alignment. In some cases, eyeglasses or special lenses (prisms) placed in a pair of glasses may help fine-tune the way both eyes work together.
Three months later it seemed to be working but her left eye was now dominate.
New plan is to patch the left eye for 3 hours a day, every day.
Three months later (six months into the treatment) there was no change.
The same as last time.
Staying with the same plan until our next visit with the possibility of talking surgery if it doesn't get any better.
Today when we went to see Dr R., Bella's Strabismus was worse.
Dr R firmly believes that the next step should be surgery.
The longer we wait she could loose sight in her right eye.
Today we went over the risks and moving forward we think surgery is Bella's best option.
The risks include:
Anesthesia: as with any ones first time under anesthesia it is the biggest risk.
If they go to deep (meaning the Dr cuts to deep) there is a possible risk for retinal detachment, if the Dr sees this (which she says she usually will know and see it during the operation) she will call in the retina team and they will assist. If the retina detaches she could loose that vision in that eye. When I asked if that has ever happened to her during her 10's of thousand's of times she has done this surgery (which I also asked her how many times she has done this surgery) she said that it has only happened 3 times and each time the retina team was called in and no one has lost eye sight.
Another risk is the possibility she may need additional surgery's in the future.
This is more of a risk if we wait.
While it is a risk either way, if we wait since her brain is still developing it is more likely to reteach after the surgery. Since her eye has been drifting for a year now, it will take a few weeks for her brain to get used to not drifting.
A risk that is higher due to Bella's features is over correction. The Dr said from the beginning that they were surprised that I caught her Strabismus so early due to the bridge of her nose.
Apparently it gives the illusion that her eye's are crossed.
This puts her at a higher risk for over correction (which means she may need another surgery).
In the next few days we will hear from the Dr when Bella will have her surgery.
Here are some pictures of Bella's beautiful eyes.
Below her pictures I added some online information about the surgery.
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
.JPG)
Online information:
From a Web site:
The surgical procedure for children with Exotropic (outward) Strabismus involves a weakening of the outside (lateral rectus) muscles. In some instances, this recession may need to be complemented with a resection of the inside (media rectus) muscles. For children with Strabismus and who have not developed Amblyopia, surgery is typically necessitated. It is expected that with age, a child will benefit from improved depth perception. The typical surgery for Esotropic Strabismus is muscle recession of the inner eye. Surgery may be required for one or both eyes. In some instances, the recession is complemented by a resection of the muscles of the outer eye. The typical surgical procedure for Hypertropic Strabismus involves a weakening of the deviated muscle and a repositioning of other muscles on the eye.
The level of success or complications from Strabismus surgery varies from individual to individual. The most severe complications may include retinal detachment or Endophthalmitis, which is inflammation of the eyeball. These complications are rare and result from an accidental perforation of the eye globe during surgery. Other complications that are typical for any surgical procedure, such as infection, bleeding and scarring may also result. Some discomfort may be experienced from the sensation of foreign bodies in the eye. Strabismus surgery is usually performed as an outpatient procedure, but patients in poor health may require hospitalization. Recovery is typically within days of the surgery.
From another web site:
Understanding Strabismus Surgery
To understand how strabismus surgery works, consider that each of your eyes has six outside (extraocular) muscles controlling eye movements.
If a muscle is too strong when you have strabismus, it may cause the eye to turn in, turn out or rotate too high or low.
On the other hand, an eye muscle weakness in certain cases may also cause misalignment. This condition may occur if you have a cranial nerve dysfunction affecting how eye muscles control movement.
Fortunately, your ophthalmologist has various surgical options to help correct these types of problems.
Strabismus Surgery Involving Recession and Resection Procedures
In a recession procedure, your eye surgeon detaches the affected outside muscle (extraocular muscle) from the eye and reattaches it (resection) farther back on the eye to weaken the relative strength of the muscle if it is too strong.
In contrast, if the muscle is too weak, your surgeon may use a recession procedure to reduce strength of the opposing muscle (antagonist) to achieve more balanced function of the eye muscles.
In certain cases, a resection procedure may be used to strengthen an eye muscle to correct misalignment associated with strabismus. If you have inwardly turned eyes (esotropia), the surgeon may strengthen the lateral rectus muscles — located on the side of each eye, toward the ear — by reattaching the muscle in a different location (resection). In this way, the lateral rectus muscles are relatively strengthened and they can turn the eyes farther outward. This results in better eye alignment.
What To Expect After Strabismus Surgery
Your eyes will be red and somewhat sore after strabismus surgery. You probably will see obvious bright red blood in the surgical area, usually toward the inside or outside corner of the eye. This is normal and is equivalent to bruising of your skin.
Eye redness should fade within two to three weeks. You may feel like something is in your eye, but this sensation will subside. Usually you can resume normal activities within a few days.
During the first few days after surgery, eye alignment is a good indicator of the final outcome. However, more permanent results may not be known until four to six weeks after surgery.
Children younger than 10 will very likely need a second or third strabismus procedure to maintain the best possible eye alignment. In some cases, eyeglasses or special lenses (prisms) placed in a pair of glasses may help fine-tune the way both eyes work together.
1 comment:
I love my beautiful hazel eyed Goddaughter. Will be praying for all to go perfectly. xoxo
Post a Comment