An effective means to restore vision without surgery and doctors, recommended by our readers!
Strabismus, heterotropy, or strabismus is called a failure in binocular vision, when there is an incorrect coordination of the eyes on the object in question. One or two eyes deviate from the center of the axis of vision in the direction of the nose or temple, as a result of which the fixation of the eyes on the object is disrupted. If no correction methods help, strabismus surgery eliminates.
Definition of strabismus and correction methods
Strabismus is considered to be a childhood disease, as it manifests itself in childhood. The occurrence of strabismus in adults is much less common, which is often caused by a malfunction of the nerve joints. The reasons for the occurrence of strabismus are not enough:
- Head injuries;
- Genetic predisposition;
- Psychological herbs;
- Poor circulation of the brain;
- Infectious diseases of the brain;
- Incorrect treatment of myopia and hyperopia;
- Excessive eye strain;
- Violation of the work of extraocular muscles.
Checking strabismus covers a holistic analysis of the organs of vision - the work and location of muscles, the fundus and visual acuity, the angle of strabismus and the age of the patient are evaluated. In the presence of strabismus, an operation is not immediately prescribed, they are first tried to eliminate it without surgical intervention. Treatment has three subsequent stages:
- Optical correction;
- Pleoptic treatment;
- Orthoptic treatment.
Optical correction is a treatment with the help of correctly selected glasses, lenses to create optimal conditions for the functioning of the eyes. If there are concomitant diseases (myopia, hyperopia, astigmatism, infections) then their treatment is carried out at this stage of therapy.
Pleoptic treatment is aimed at increasing and equalizing the acuity of both eyes to age norms.
Orthoptic treatment is essentially a preoperative stage. It is advisable to conduct it only after the relative equality of visual acuity between the eyes is created. His goal is to develop the patient’s ability to turn on binocular vision (the ability to clearly see an object with two eyes) while looking away in different directions. In the absence of binocular vision, the question may arise about the prohibition of the operation. Symmetry of the eyes is possible only with the same spatial perception of objects, objects with both eyes.
It is prescribed only when the maximum possibility of visual functions in both eyes is achieved.
Strabismus surgery
All operations, the purpose of which is to correct strabismus, are to correct the work of the oculomotor muscles - strengthening and weakening. Manipulations are carried out only within the framework of traditional surgery, laser strabismus correction is not practiced. Surgical treatment of strabismus involves dissection of the muscle, and this cannot be done with a laser.
The goal of strabismus surgery is to restore muscle balance and binocular vision. But often it is only cosmetic defects that can be improved, the restoration of visual functions after surgery requires an integrated approach and active conservative therapy. In ophthalmology, there are three areas of surgical correction of strabismus:
- Muscle weakeners;
- Strengthening traction;
- Changing the direction of muscle action.
Weakening muscle cravings include:
- A recession, which involves surgery, as a result of which the laxative effect of muscle traction is formed, achieved by shifting the place of muscle attachment to the beginning of the muscle.
- Myoectomy is a procedure to remove a specific muscle from its attachment site. Basically, an indication for such an operation is hyper-contraction of the muscles.
- Back fixing sutures - a procedure consisting in a recession with sequential hemming of the abdomen of the displaced muscle to the sclera, slightly behind the place of its attachment.
Aimed at restoring weakened oculomotor muscles:
- Resection is the process of excising a specific area of \u200b\u200ba weakened muscle at the site of its attachment, followed by its fixation. Essentially stitching of the remaining sections occurs.
- Tenorography is a process of muscle shortening by creating folds in the area of \u200b\u200bthe muscle tendon. As a result, the shortened muscle is significantly enhanced in terms of contractile function.
- Anteposition - the process of changing (transporting) the place of muscle fixation.
Advantages of surgical ophthalmology:
- Low invasiveness;
- The structure of the eye is preserved;
- Accuracy of operation;
- Small% of consequences;
- High guarantee of a good result;
- A short period of rehabilitation.
Surgical intervention to eliminate strabismus does not give a 100% guarantee for a full correction, but the chances are great - up to 80%. If strabismus persists after the manipulation, the operation can be repeated, after six months. You should not expect that right after the operation you will be “right” to see. During the time that a person suffered from strabismus, the brain was weaned, forgot how to compare visions from both eyes into one image, and it will take him a long time to learn how to do this. As with any operation, complications can arise here. First of all, these are calculation errors leading to repeated strabismus.
The strabismus operation is performed under full or local anesthesia (according to indications) on an outpatient basis, the hospital is not required - a few hours after the operation, the patient is released home. Ophthalmic surgery, like all others, is performed on an empty stomach. All necessary analyzes are taken in advance. During the patient should be absolutely healthy (no acute respiratory viral infections, temperature, infections). The procedure does not exceed 30 minutes on average. After surgery, a special dressing is applied to the patient, which is left for 12-24 hours. The overlapping seams give the sensation of a foreign object in the eye, they are not required to be removed, they dissolve within 6 weeks after application. After surgery, the patient needs the use of anti-inflammatory drops. When suppuration, rinsing will be indicated.
The following actions must be performed:
- Carefully protect the eye from contamination;
- Do not engage in physical labor for the first three weeks after surgery;
- Do not swim in public places;
- Do not disturb the eye, do not rub it.
After surgery, careful eye monitoring is required. A regular visit to the ophthalmologist, the use of necessary preparations and eye relaxation are necessary. To restore muscle, a special system of exercises is developed that must be performed. Assessment of the position of the eyes is checked no earlier than two months after surgery.
In secret
- Incredible ... You can cure your eyes without surgery!
- This time.
- Without going to the doctors!
- These are two.
- In less than a month!
- These are three.
Follow the link and find out how our subscribers do it!
Despite the fact that strabismus is usually detected in preschool children, some adults also suffer from this ailment. Strabismus is a lesion in which the visual axis of one eye deviates from the joint fixation point. Visually, it looks like the eyes of a person are looking in different directions. Conservative therapy only improves if a deviation is detected on time. In other cases, only surgery will help correct the situation. How effective is the correction of strabismus in adults, the prices of which vary between 35,000 and 40,000 rubles, and in what ways is the correction carried out?
Reasons for the development of strabismus
Before you try to figure out what triggered the development of strabismus, you need to identify what form of defeat a person has encountered. Strabismus is congenital and acquired. Each of the forms develops for various reasons.
Congenital strabismus is quite rare and more often detected immediately after the baby is born. But experts warn that such a violation is often "false." Due to the weakness of muscle fibers, some children cannot focus their eyes on their own. This creates the impression that the child develops a pathology. As for true congenital strabismus, the disease can develop against the background of childhood central paralysis or Down syndrome. Also, the violation can be caused by a genetic predisposition. Pathology often develops if during pregnancy a woman was sick with infectious diseases and took potent drugs on an ongoing basis.
The acquired form of strabismus is also more often manifested up to 12 months, but there are cases when the pathology makes itself felt at an older age. Most often, the role of a provoking factor are:
In adults, strabismus often develops as a complication after severe flu. But this is only possible if a person has a predisposition to pathology since childhood.
If an adult patient is diagnosed with a strong form of strabismus, correcting the situation is possible only with the help of surgical intervention. Conservative methods give an effect only in the initial stages. Most experts recommend an operation to correct strabismus in several steps. This is due to the fact that surgery on more than 2 muscles at a time can be dangerous, and increases the risk of complications.
Elongation or shortening of the affected muscles is always carried out evenly on both sides. The size of the excisions should also be identical. If there are indications for an intervention, the patient should be very careful about the choice of clinic and surgeon, since the result largely depends on the experience and qualification of the physician.
If financial opportunities allow, it is better to carry out an operation to eliminate the pathology from German and Israeli specialists. In these countries, the technology for correcting ocular muscle fibers is more advanced, due to which it is possible to eliminate the ailment at a time.
Is the operation dangerous
The eyes are one of the most vulnerable organs, so any ophthalmic surgery involves some risks. As medical practice shows, the most common complication after eliminating strabismus is the appearance of a double image. In more than 70% of cases, this deviation disappears on its own some time after the operation, but sometimes the complication remains.
It is also worth considering that the course of the operation and the further condition of the patient largely depend on the initial state of human health. The younger and healthier the patient, the faster recovery will go and the lower the risk of postoperative complications. If the operation is performed in a modern clinic with high-quality equipment under the supervision of an experienced doctor, the risk of negative consequences will be minimized.
Indications for
A strabismus correction surgery is usually prescribed if:
- the patient was prescribed various methods of conservative treatment of strabismus, but they did not bring positive changes or the improvements were insignificant;
- the patient wants to get rid of strabism as soon as possible. If conservative therapy usually lasts 2-4 years, then the operation will help eliminate the defect in just a couple of months (along with the rehabilitation period);
- the patient is diagnosed with a strong stage of strabismus. In advanced cases, doctors are advised to first have an operation, and only after that conservative treatment methods are prescribed. Most often they are used to consolidate the achieved result.
Before the operation, the patient must undergo a full examination and make sure that there are no contraindications, since some individual characteristics are a limitation to such a correction.
Types of Surgery
The main task to eliminate strabismus in adults is to change the incorrect position of the eyeballs in the visual apparatus. The correction method is selected individually for each patient. In this case, the doctor takes into account the initial state of the person and the degree of damage. Also, the technique is selected taking into account what exactly needs to be done - to weaken or strengthen the muscles.
Correction of strabismus in adults, the purpose of which is to strengthen muscle fibers, is carried out in one of the following ways:
- resection - shortening the affected muscle with further fixation;
- prorafia - muscle strengthening by moving the tendon forward or backward;
- tenoraphia - the formation of a small fold of tendons. Such an operation is performed so that a person can see better.
To date, the most popular way to strengthen the eye muscles is resection. This is due to the fact that other methods of strabismus correction are more aimed at correcting the oblique muscles of the eyes.
If it is necessary to loosen the muscles, the surgeon disconnects them and fixes them away from the cornea. Such an operation is carried out using the following methods:
At the initial consultation, many patients are interested in whether it is possible to correct strabismus using laser correction. It should be borne in mind that laser techniques are used only to correct visual acuity, but it is impossible to change the position of the eyes with it.
Postoperative period and complications
Since the operation to eliminate strabismus is performed on an outpatient basis, the patient does not even have to go to the clinic to perform it. In most cases, a person is allowed to go home within a few hours after surgery. The patient is left in the hospital only if there are certain health problems or the occurrence of postoperative complications.
The postoperative period is usually no more than a week, but the rate of recovery of vision largely depends on the body itself. After 4-6 hours after surgery, a person may feel severe discomfort and a sensation of a foreign object in the eyes, minor headaches. Such symptoms usually persist for 3-4 days, after which the condition begins to normalize and a person can return to their usual lives. To minimize the risk of complications, for the first time after surgery, the patient should avoid outdoor activities and heavy physical exertion.
Full recovery usually lasts from 4 to 5 weeks. To speed up the regeneration process, you need to use special ointments and gels prescribed by your doctor. Also in the postoperative period, it is useful to do gymnastics for the eyes.
As for the complications, after the operation to eliminate strabismus they are quite rare and more often due to negligence or medical errors. The most common complication is hypercorrection. Pathology develops with excessive lengthening or suturing of the eye muscles. A similar violation appears due to the following reasons:
- medical error;
- incorrect initial calculations.
In order to minimize the risk of complications, today more often operations are performed not with cutting, but with suturing of muscles. This technique allows you to adjust the stitched seam. If the patient has undesirable effects, they can be eliminated by a minimally invasive method.
Also, the patient may encounter such pathologies:
- scar formation in the area of \u200b\u200bexcision of muscle fibers. Pathology is dangerous because with it the muscle loses its elasticity and mobility, and in its place fibrous tissue begins to form;
- secondary strabismus. Usually occurs if the patient ignores medical advice during the recovery period;
- injury to the vagus nerve during surgery. This injury is very dangerous, since the vagus nerve is responsible for the functioning of the myocardium, lungs and gastrointestinal tract.
Operation cost
The price of surgical correction of strabismus depends on the type of medical institution, as well as on the chosen technique. If a person goes to the municipal hospital, the procedure will be performed free of charge. The service is provided for patients of all ages, regardless of the form and stage of the lesion. In private clinics, the cost of the service depends on the complexity of the operation. The average cost of such an intervention in Moscow and other large cities of Russia is 38,000 rubles.
For treatment of strabismus to be effective, you need to carefully approach the choice of clinic and surgeon. Also, success largely depends on how the rehabilitation period went. In order to minimize the development of complications and consolidate the result, the patient must strictly follow all medical recommendations and regularly undergo a routine examination by an ophthalmologist.
There are certain problems of the oculomotor system in which changes leading to the alignment of the eyes during the healing period [after surgery] are fairly predictable. For example, when a child undergoes surgery to correct exotropia (divergent strabismus), during the healing period, the eyes tend to diverge ( divergence) an average of 5 degrees. For this reason, for perfect eye alignment [in the future] in some children immediately after surgery for correction exotropia eyes should be “excessively” corrected by several degrees (while they look like exotropic or squinting inward) so that when the eyes open slightly during healing, they will become straight. In a person suffering exotropia, the brain is used to diverging eyes ( divergent), and he learned suppress [image] deviating eye. He is not used to eyes turned inward (a convergent squint) and “does not know how to suppress” an oblique looking eye. Therefore, when after such an operation the eye is turned inward, temporary double vision is often seen in the eyes, this is a common phenomenon. This usually lasts several days or weeks. If the double vision does not disappear, you may have to treat it with eye drops, glasses, prisms, or another operation. In most cases, temporary double vision after surgery for squint predictably, and there should be no reason for concern or concern about this.
Question: My daughter exotropia. When she looks at me, I see that only the left eye is not looking in the center, and I have never seen her have any problems with the right eye. Her doctor wants an operation on both eyes. Why?
Answer: Your doctor’s recommendation may be appropriate. Don't think about divergent strabismus your daughter’s only left eye problem. Imagine that both her eyes do not look in the same direction, but diverge. But, when she looks at you, she must use either the right eye or the left. Otherwise, she will not look at you. If her right eye is dominant (just as your right hand can be more coordinated than your left [if you're right-handed]), then with a choice, she always chooses to look with her right eye. Therefore, you constantly see only the left eye deviating. All you have to do is evaluate her gaze with the left eye (possibly closing her right eye at the same time), and maybe you will see that the right eye deviates as far from the center as the left one (see again same Figure 6-2 on page 59). You will never see the left eye deviating by itself, because it does not look with the left eye, if it is possible to choose one eye or the other.
271 10/22/2019 5 min.The operation to correct strabismus (strabismus) is a radical and effective method of eliminating this defect. This manipulation is recommended in advanced cases. In less severe situations, they try to correct strabismus using gentle methods. Surgical intervention does not guarantee a complete restoration of lost vision, but allows for a more symmetrical relationship between the organs of vision. There are several methods of surgical intervention. The choice of a particular one depends on the severity and type of violation.
Indications for surgery
The most favorable age for surgery aimed at correcting vision in children is 4-6 years, but, in case of congenital pathology, it can be performed earlier - in 2-3 years. In the period from 4 to 6 years, it is best to determine the strabismus angle. somewhat more complicated.
The operation to correct strabismus, or strabismus, is prescribed for both adults and children.
Indications for surgical intervention for strabismus are:
- lack of results, that is, achieving a symmetrical position of both eyes, after conservative treatment;
- strabismus caused by eye injury;
- desire to correct a cosmetic defect that occurs with strabismus;
- double vision, which is especially characteristic of older children, as well as adults who first encountered eye pathology;
- severe paralytic strabismus;
- damage to two organs of vision at once.
Read more about the treatment of paralytic strabismus.
One intervention is not always enough to correct strabismus, in some cases a whole series of operations is required.
Preparation for surgery
Proper preparation is no less important than the operation itself. It includes the normalization of both the physical and psychological state of the patient (which is especially important for children). First of all, a patient is examined to identify existing abnormalities. Also, before the planned operation, it is necessary to carry out measures for the rehabilitation of ENT organs and the oral cavity. The best strabismus exercises are compiled by.
Ophthalmic preparation is the most important stage of the preoperative period. Depending on the form of strabismus, the following measures are required:
- elimination;
- oculomotor muscle training;
- synoptophore treatment;
- coordinate survey.
- An ECG is also prescribed before surgery.
Preparation for surgery can take from 3 to 6 months.
Varieties of surgical methods
All varieties are divided into two main groups:
- manipulations aimed at weakening the action of muscles;
- operations that enhance muscle action.
The first group of surgical interventions that are carried out with strabismus include:
- recession of the oculomotor muscle. The essence of the operation is to remove tissue at the site of attachment, after which the muscle merges with the sclera and tendon. As a result of such manipulations, the fiber moves back and its action is weakened;
- partial myotomy. This method involves cutting off the muscle, but without further suturing.
The course of the operation to correct strabismus.
Another way to conduct surgery is to suture the muscle immediately to the sclera with non-absorbable threads.
If it mows only one eye, then the operation is performed on it. If a violation is observed immediately on both organs of vision, then the intervention is performed on each of them.
Even if a child or an adult has a significant strabismus angle, it is not recommended to act on more than two muscles simultaneously. In the event that after the intervention the angle with strabismus remains pronounced, re-treatment is carried out, but not earlier than after 6-8 months. The main causes of strabismus are described in.
Usually, when performing an operation on the eyes with a mowing angle, all 6 oculomotor muscles that hold the eye in its natural position are affected.
Principles of Intervention
To achieve the best results from surgical therapy, you must adhere to the following key principles:
Foreign clinics are set up for a more radical solution to the problem: in medical institutions in Germany and Israel, they correct their eyesight immediately, in one operation, even if strabismus spreads in both eyes. Also in these countries, children undergo surgery at the age of up to one year.
Operation progress
8 hours before the start of the operation, you can not eat. If it is appointed in the morning, then in the evening on the eve you can easily have dinner. An intervention is performed under general anesthesia. In general, it lasts 30-40 minutes.
In general, the correction is performed in this way:
- after the anesthetic begins to act, the eyelids are removed with the help of special devices - spacers;
- a sterile oilcloth with a slit for the eyes is applied to the face;
- the specialist makes an incision of the sclera and conjunctiva, opening access to the muscles;
- the eye is periodically wetted and constantly kept in the correct position;
- the muscle is pulled out through the incision;
- the tissue is cut or sutured, and then sutured.
After the procedure is completed, a bandage is applied to the eye, which is removed the next day.
If the deviation angle in children under the age of 5 years is more than 45 degrees, then the operation is carried out in 2-3 stages. First, the strabismus angle is reduced.
Hospitalization is usually not required and the patient may return home on the same day. Is it possible to treat strabismus in adults at home described.
There is another way to correct strabismus. This is a more modern method, which is high-tech - high-tech surgery. In this case, strabismus is corrected using mathematical modeling and radio wave surgery.
Postoperative period
After surgery to correct strabismus, an adult or child needs a recovery period. It takes about a month, while in children it is easier and faster. During this time, you must adhere to the following recommendations:
After correction, the following complications may occur:
- re-development of strabismus. This is possible if the patient does not follow the recommendations given by the doctor in the postoperative period;
- scarring, which makes it difficult to move the eye;
- vagus nerve damage. This is a very dangerous complication, since he is responsible for the work of the heart muscle, lungs, and organs of the gastrointestinal tract.
Video
This video will tell you about the operation to correct strabismus.
findings
- Surgery to correct strabismus is prescribed for adults and children over the age of 4 years.
- in difficult situations, the operation is carried out in several stages. It is not recommended to affect more than 2 oculomotor muscles at a time. Operations are carried out with, and other types of strabismus.
- before surgery, preparation of the patient for the event is mandatory. This is especially true for children.
- duration - about half an hour. The recovery period lasts about a month.
- to avoid complications after surgery, you must follow all the recommendations given by your doctor.
An effective method of therapy is surgery for strabismus, with its help it is possible to correct a defect in the visual organ. It is recommended if there are no other options left, and conservative treatment does not give positive results. As with any surgery, unforeseen complications can occur with this procedure. Before deciding on an operative measure, it is necessary to consult an ophthalmologist and undergo a diagnosis.
Indications for
Doctors recommend treating the disease in childhood (4-6 years), since in children the therapy is more effective. If conservative methods do not give visible results, and the pathology does not go away, then strabismus needs to be corrected surgically. Eye surgery is recommended for indications such as:
- desire to correct a cosmetic defect;
- squint in a neglected form;
- strabismus due to traumatic injuries;
- visual impairment (double vision);
- inefficiency of other therapeutic methods.
In order not to cause a postoperative complication, you need to wash only with boiled water, do not use soap.
Types of operations
Laser surgery is less traumatic.
The most commonly used methods for restoring visual function are laser treatments and a technique called recession. After a visual examination by an optometrist and diagnosis, a method is selected. What type of treatment for strabismus in adults and children should be addressed, the attending doctor determines. The patient’s age, eyeball condition, muscle location, strabismus angle are also taken into account.
In adults, local anesthesia is used during manipulations, in babies - general. The operation to correct strabismus in children often does not last long. Before surgery, hardware exercises for the eyes are recommended. The course of orthoptic exercises on synoptophore is up to 14 days, it is prescribed in order to develop a sick eye. In difficult cases, classes are extended up to 6 months. And also the doctor always advises to donate blood for analysis, ECG, if necessary, consult with specialized specialists. Do not eat or drink before the procedure.
Types of eye muscle surgery
Procedure name Features Myectomy Seamless surgical excision of the eye, rectus muscle Operation Faden Muscle tissues are not trimmed, they are hemmed with threads that do not absorb, directly to the sclera of the eye Recession of the oculomotor muscle In the place of attachment, tissues are cut off, then they are sewn to the tendon or sclera Thanks to these manipulations, the surgeon weakens or strengthens the muscle Partial removal of muscle tissue It is partially shortened by resection, this enhances the oculomotor muscular system The formation of a fold inside or between the tendon and muscle The procedure is carried out on the same principle as resection of muscle tissue. How is it carried out?
As a result of the operation, a good therapeutic and cosmetic effect is achieved.
After the anesthesia began to work, the doctor with special tools opens the eyelids and fixes the eyeball. Before starting the procedure to remove the pathology, a special sterile mask is applied to the patient's face. The surgeon makes an incision on the sclera and conjunctiva, and takes on the muscular system. He is surely assisted by a nurse, who periodically moisturizes the visual organ, and helps to keep him in the right position. Then the surgeon draws a muscle through the wound and carries out manipulations with it, sutures the hole. Often, a microscope is used as an auxiliary technique.
So that the baby does not develop vertical strabismus, oculists recommend that toys not be hung on the crib above the child’s head.
After surgical treatment of friendly strabismus, a protective dressing is applied to the operated eye, in the normal condition of the patient it can be removed in a day. When the surgeon finishes, the patient will not be under the dropper for long. After the anesthesia passes, the person is released home. To prevent complications, the use of eye anti-inflammatory drops, antihistamines is prescribed, a special charge is done. Sometimes pus may appear on the eye in the mornings, so doctors recommend washing the eye with a decoction of chamomile inflorescences (rinsing from the outside of the eyelid is very carefully done).
Complications after surgery
Slight redness and swelling should pass after a few days.
The most dangerous and negative consequence include damage to the vagus nerve. Since he is responsible for the operation of such vital organs as the heart muscle, lungs, and gastrointestinal tract, improperly performed surgery can do much harm, even death. Sometimes, due to a surgical error in the conduct or calculations, hypercorrection may occur. Side effects also include scarring, swelling. Due to the patient's non-compliance with the doctor's recommendations, the consequences can be adverse. Perhaps the development of repeated strabismus, you will need to do the operation again.
