Saturday, June 11, 2011

Should you get strabismus surgery?

I'm going to deviate from my normal topic for a moment and discuss my rare eye condition, as I know there are others out there like me who look for information about it on the internet. Here's my story, in completely lay terms:

I was born with Duane's syndrome (my right eye can't look to the right or to the left). I used an eye patch briefly when I was a kid and wore special glasses to help make the eye stronger.

I was born with both eyes able to look straight ahead when my head was faced straight ahead. As I got older, I had to turn my head increasingly to the left in order for my eyes to line up and work together. If I didn't turn my head, one eye would be focused on the object in front of me and the other would be off doing its own thing. For the most part I didn't notice it. It happened so gradually that it had just become second nature to me. But as you can see, over the years it had become pretty severe:

Looking "straight ahead"
I conversed this way, read this way, and even drove this way. A couple years ago I went to a top medical school and had surgery to correct the strabismus. It was a Children's Hospital, as strabismus affects mainly children, but the surgeons there will of course fix the problem at an age. I was put under general anesthesia and my pupils were sutured and pulled into a correct position.

While I am for the surgery and not against it, here's some information you'll want to know ahead of time to help make your decision and to make sure you have the best recovery possible:
  • Don't take any Ibuprofen for a week before the surgery as it acts as a blood thinner.
  • After the sutures are in place, you will be asked to wake up and wait for the anesthesia to wear off, and then the opthamologist adjusts the sutures as necessary.
  • As you're coming out of the anesthesia, it will take awhile to be able to open your eyes, and if they put a breathing tube down your throat, you may have a hard time talking at first.
  • If it's too painful to get the sutures adjusted while you're awake, it's possible for the anesthesiologist to put you back under for the surgeon to complete the procedure.
  • There will be a lot of post-op bleeding (bloody tears) that may take several days to go away.
  • Your eyes may feel sandpapery for several days.
  • If the sandpaper feeling doesn't go away after a couple of weeks, you may need to go in to get the exposed end of the suture trimmed, which is not painful.
While my recovery was more difficult than most, the outcome was definitely worth it. And while it is mostly a cosmetic procedure, insurance does cover it. Or at least it does in some cases... I can only speak for myself! Now that my eyes are aligned, I no longer need 10 and 12-strength prisms. I look invested in the person I'm talking to instead of annoyed or flippant, and I have become a better driver.

Hope this helps!

--Shannon Luders-Manuel



  1. Oh interesting! I never really noticed this about you! Funny. I'm sure it must've been annoying to live with though. I'm glad they make surgery for that if people want it.

  2. I learned to hide it well. :) But if you look through my old facebook pictures, pre-surgery, you can see that my head is turned the same direction in every single one!

  3. HI I'm just learning about possible surgery for Strabismus. I had surgery when I was a toddler but it didn't completely help. My problem is slight, and most won't notice but it's a wreck on my self esteem. I could never look anyone straight on, pictures I'm always facing to the left. I get extreme anxiety when I'm doing passport/ID photos and they ask for me to look straight and so on... I feel as though I'm young (24) and I don't want to live the rest of my life like this.. Not sure if my insurance in NYC will cover and I'm hoping I could work out a payment plan.
    The recovery time will be my roughest as I never spoke to any of my friends about this and it will be embarrassing to bring it up. I had a rough childhood and I cringe whenever someone looks behind them whenever I'm looking at them. You know that feeling ugh.
    So...I'm really thinking of it...
    How much did it cost?

    Did you have double vision? Because of this problem I have lowered vision and once a doc told me if I got laser eye surgery I'll see double...but I think this stabismus surgery is different (right??).

    Was it painful during the procedure? after? what problems did you face?
    Sorry for the essay :(

    I stumbled on your website in google and I'll prob forget to check for your reply..can you email me? :

    Also I just realized why I cannot see 3D movies, because of my eyes!!! how wack! I have bad depth perception :(

  4. Hi Anonymous,

    Glad you found my post! I'll email you privately as well, but I want to also comment here in case my answers can help others.

    Firstly, there's a good chance your insurance will cover it. Everything you're going through... ID people telling you to look straight, people looking behind them when you're talking... are the same things I went through. Eye surgeons completely understand what we go through and are totally behind surgery. If you come across one that isn't, see if you can find another one. The surgery helped my depth perception which is I think one of the reasons why it was covered. So it's not completely cosmetic, it does have physical benefits.

    Strabismus surgery is in fact different from laser eye surgery. I won't lie, it is a painful recovery, but you get good drugs to help you through it. ;) I had some excessive bleeding, partly because I didn't notice on the forms that I wasn't supposed to take ibuprofen for a week prior to the surgery. I noticed about four days before the surgery, but because I'd already taken some, my blood had thinned a little. I also had a suture that was too long and it took awhile to figure out why my eye was hurting so badly, so once that got snipped I healed a lot faster. Overall I think it took two weeks, though I was able to do most things after one week, just not anything that required long stretches of looking at things.

    About doing it on your own, you definitely need someone to take you home after the procedure. They won't dismiss you otherwise. I took myself there but had a friend pick me up. It took a few hours for me to be able to fully open my eyes. It wasn't painful at all during the procedure, because you get put to sleep, but after the procedure is complete, the anesthesia is supposed to wear off and then the surgeon tugs at the sutures to make sure they're in the right place. I couldn't tolerate that AT ALL, so they had to put me back under for that part. The procedure worked perfectly even with that glitch and my eyes continue to be completely centered.

    Lastly, no, I never saw double. The surgeon said my eyes compensated by working completely independently and taking turns which one was doing the "seeing." That being said, I did have some weird things like being able to look at sheet music on a stand and being able to see behind the stand at the same time, since each eye was seeing something different.

    Good luck, and I really hope you get the surgery! It's so worth it!

  5. P.S. By "excessive bleeding," I mean that my eyes would water with bloody tears that I'd have to dab with a tissue. So excessive in terms of eyeballs, but not in terms of how it compares to most surgeries. :)