Why would someone have a ‘lazy eye' corrected?
Amblyopia, or “lazy eye” is the loss of one eye's ability to see details, a common cause of vision problems in children. Sometimes amblyopia is present first, and it causes strabismus, misalignment of the eyes that's sometimes referred to as “crossed eyes.” Surgery might be recommended when strabismus does not improve with glasses or eye exercises.
Surgery is more common in children. There are some visual benefits to a surgeon correcting the condition earlier in life. When your eyes are lined up, you can use them together and have better depth perception, among other things. There are some social, or cosmetic, benefits to surgery as well.
What happens during surgery?
The details of your surgery will depend on what kind of misalignment you have and the extent of the issue.
For example, if your eyes or your child's eyes are turned in, your surgeon might take the muscle that pulls the eyes in, the medial rectus, and weaken it in each eye. In other instances, your surgeon might strengthen an eye muscle. It depends on how the eye is positioned.
Before your surgery, you will have a complete eye exam. Your doctor will look at your eye's alignment and take measurements. Your doctor might use a prism, which bends light to measure how much the eye is deviating. Based on these measurements, your doctor will move your eye or eyes' muscles accordingly.
The surgery is generally an outpatient procedure, meaning you go home afterward, and you'll usually placed under general anesthesia, in which you fall asleep and do not feel the surgery.
Does it hurt?
You shouldn't feel anything during surgery. After surgery, your eyes might feel scratchy, like getting something in your eye. It likely will be irritating, but as the stitches soften and dissolve, it gets better.
Children usually can take children's ibuprofen, or Motrin, or acetaminophen, or Tylenol.
Adults generally have a harder time with the surgery. They're usually prescribed prescription pain medication and need to take about a week off work. After the surgery, adults will notice their eyes are sensitive and their vision might be blurred.
What are the risk factors to surgery?
Left untreated, a lazy eye can cause permanent vision loss.
The risk factors related to the surgery itself include bleeding and wound infection. There's also a risk of damage to the eye or permanent double vision, but these risks are rare.
As with any surgery, you should research the procedure and ask your doctor any and all questions you have.
What's the recovery time?
Children aren't always good at noticing or explaining any noticeable change in their vision. Adults usually notice quickly after surgery.
After surgery, children usually don't have to wear an eye patch. Adults might have to. Often with adults, an adjustable suture is used on the weakened eye muscle. This suture is left so that your doctor can perform minor corrections. You usually come back shortly after surgery, usually that same day or the next day, and have the corrections.
Children usually return back to their normal routine after a few days. Adults usually take up to a week off work.
What's the follow-up?
There's between a 20 percent and 25 percent chance that your doctor will under or over correct during surgery. This means that you might need another surgery later in life. Doctors base the amount that they correct on previous experiences, prism measurements and charts.
However, it can be difficult to know an exact amount they should correct your eye problem. Sometimes, doctors over or undershoot the target. If it's a small amount, your doctor might not correct it. However, if it's a larger problem, you or your child might undergo another surgery.
With adults who have their eye adjusted after surgery, the outcome is usually good, and they generally don't need another surgery.
Sources: Dr. Tammy Yanovitch, a pediatric ophthalmologist at Dean McGee Eye Institute; the U.S. National Library of Medicine; the Mayo Clinic; American Optometric Association.