Friday, September 10, 2010

O's Bilateral Strabismus Repair Surgery

This past Wednesday my middle son under went Bilateral Strabismus Repair Surgery, or more simply corrective surgery to fix 2 "lazy" eyes (eye muscle surgery). The doctor goes into the corner of his eyes cuts the muscle that attaches to the eye and reattaches the muscle so it is "shorter" or tighter. In O the left eye was predominately more "lazy" or noticeable but really both needed correcting. This is often seen as cosmetic surgery but for O, his left eye was so bad his brain was shutting off the connection to his eye and this will help at least keep the connection and maybe help reform it and make it stronger. His vision may or may not improve in the left eye but in the very least it won't continue to lessen and have the potential of blindness. Obviously not just a cosmetic procedure for him!

(Before the surgery)
The Journey: Somewhere between 1-1.5 we noticed O was crossing his eyes occasionally, not anywhere near all the time but once in a while. We chalked it up to him being funny and even mentioned it to his ped at his 15 mth appointment and she agreed. But somewhere around 18 mths it was happening way too often to be comfortable with and so at his 2 yr check-up I brought it up again to his ped and she gave us 2 referals- one for an MRI and another to a Pediatric Ophthalmologist. The MRI make back fine. The Opt found he definitely needed glasses and had a "lazy" eye. Her original treatment was just to patch him and wait. I got uncomfortable with just the waiting especially since his eye sight was just continuing to worsen, so made the decision to switch doctors. His next doctor was a bit gruffer but thought doing the surgery to fix his eye an important issue and wanted it done sooner than later. It's been just 6 months and he's had the surgery, compared with his old doctor who we saw for over 2 years.

(a photo of O at about 19 months- you can see how his left eye turns in)

The Day- We arrived at the hospital at about 7:15am and waited just a few minutes before preceding to pre-op. In pre-op O was given new pajamas and his name bracelet (along with one for Koda the bear too!). He was weighed, temp, blood pressure, heart rate and oxygen levels taken. He got to play in the waiting area.

While waiting a Child Life specialist came to talk to him about what was going to happen that day. (I don't know if all hospitals have these or if it's just at Childrens'- these are people specially trained to talk to kids about medical procedures and help them cope or with any questions). O's supplied him with a bag FULL of medical supplies (masks, head covers, gloves, bracelets) to share with his siblings or class.

We also got to meet everyone that would be part of his medical team during surgery- the nurses, anesthsisologist team and again with his doctor.Any questions he had were answered (which was actually none!lol) and mine. I had heard kids wake up from anesthsisa pretty crabby and wanted to be prepared. His told me that's typical with kids that have tubes put in their ears but O would be fine since his was a lot longer of a surgery. And if it did seem to be an issue they would have a sedative to give him. (I didn't want to argue with him but I KNEW it would be with O- even with just a normal nap he's a crabby cuss when he wakes up!)

I was able to go back in the OR while they put him under- all dressed up in hospital garb (sorry no pics! :D). And Koda the Bear got to stay in the bed with him the whole time, even during surgery! He mumbled something about floating and flying and was out- he tried to pull away once when the smell got bad but that went fast! After he was out I was shown to the family waiting room for what I expected to be 1.5. It was 9am. Having not eaten at all that day, I decided it'd be best to leave right away and grab a quick bite in the cafeteria one floor down. (I was really surprised at the breakfast I was able to get quiet cheaply- 1 egg, slice of toast and sausage or bacon for less than $2!, and it was nummy too!)

I got back up to the room at about 9:30 and settled in to wait another hour. But just 30 mins later his doctor came in and said they're were done and everything had gone well. That O should be out of post-op and going to recovery within a half hour, after he started waking on his own. I would meet him on the way to recovery.This took O an hour. I was sent to wait outside of the post-op room and could hear him crying and screaming- he was NOT waking up nicely! The nurse finally wheeled him out, they had given him a bit of a sedative but it was not helping.

We made it down to recovery with him kicking, hitting and screaming the whole way. His recovery nurse and I tried to calm him enough to get him to speak and all we could make out was his eyes hurt. All they had given him for pain at this point was some Ibuprofen via his IV. So Morphine was given and he fell back to sleep for another 2 hours.I was left alone with him most of that time- to try and hold his hands back while also dodging kicks and holding him down while bucking. The first hour was starts and fits of broken sleep then followed by actual rest. In my honest opinion he was not given enough pain meds to be comfortable, as he continued to complain about the pain and rub and scratch at his eyes. After he woke he had a few apple juice boxes and 3 Popsicles (1 cherry and 2 grape- his choice!lol) and some liquid Tylenol. He would try and open his eyes but they were first glued shut and then the lights hurt so he never fully opened them till we got home, and then it tool B getting home from school and lavishing attention on him to achieve!

So now a few days later you can see the improvement and it should continue a bit over the next week, as the incision heals. The corner of his eyes are blood shot and again this will go away within the next few days. He is already saying his glasses don't work right- so a new Rx may be needed right away (not for strength but for center), we'll know more next week after his follow-up.

Things I've learned from this experience: 1) My child will wake up crabby! 2) Fight for more pain meds. 3) I wish this had been done either a few years ago when he was better able to handle sitting still or a few years older and had more maturity to handle it all. 5 is a hard age for it, and he did really well considering! 4) NEVER NEVER NEVER will I go alone again- I will have back up! So I can even just go to the bathroom (parents are required to be bedside at all times in the recovery room- not that I disagree with this but I was in there 4 hours and unable to even go pee, let alone go get a snack.) once or twice. It's a long time to be alone and without support.

(This should be the only time he has to have this surgery. His doctor has a personal success rate of 98% for taking, and 93% for keeping for life. Those stats are usually 95% and 85% respectively.)

He's doing well and in a few months time I'll post an update with better pictures!


  1. You are one strong mama for your little guy! I'm glad to hear that he is doing better now, so tough to experience such a hard thing at five years old!

  2. My daughter has alternating estopropia, and will be going for the corrective surgery the week of her first birthday. I'm so happy to have come across your blog. I must admit I've been really nervous about the surgery. I noticed the problem when she was about 7 months old. I kept saying that there seemed to be a problem, and everyone said she would outgrow it. She passed the enfant vision test the pediatrician gave her with flying colors. It kept nagging at me though, so I took her back in to the pedi, and he confirmed there was def a problem. He told me no matter what, to always trust my gut when it came to the kids. I will never doubt myself again! Good luck to your little guy!


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