Suggested list of questions for your strabismus surgeon

Blue question mark
Blue question mark, public domain.
George Alexanian recently provided our Eyes Apart Strabismus Support Group with a list of questions he recommends for you to ask your strabismus surgeon. He did a great job with the list in the group, and has since refined it further. George graciously allowed me to post the list here so it can be easily found by group members as well as those visiting our Eyes Apart blog. George writes:

I am not a doctor and have no medical training, so I can only make these recommendations from my experience as a strabismus surgery patient. On the first consultation, I would ask the questions which will give you confidence in this surgeon, but only ask if he has not already answered them. Tell him that if he does not mind, you have some questions to put your mind at ease:

  1. How long have you done adult strabismus procedures, and how many have you done and with what success?
  2. What is my eye deviation in diopters?
  3. What is the largest diopter deviation you have done successfully? (Mine was 50.)
  4. How old was your oldest patient? (Only if you are older than 50-I was 63.)
  5. Do you see any potential complications in my case? (previous scarring, astigmatism, etc.)
  6. What percentages of your patients have eyes that have not drifted for at least five years?
  7. Will you get insurance approval for me? If the insurance will not cover it, what is my total out of pocket cost? (He may refer you to the person who handles scheduling, insurance approval, and payments.)
  8. Could I get a couple of recent patient references?

Once you have decided on this surgeon, then during the second visit or pre-op, I would ask:

  1. Do you recommend cutting muscles in both eyes or just one eye if the other is straight? (My surgeon held my straight eye in position while cutting two muscles in my deviated eye, but most will recommend doing both eyes for best results and reducing chance of double vision.)
  2. Do you recommend adjustable sutures or fixed sutures? (I had fixed, but most will recommend adjustable also for improved appearance and reduced chance of double vision.)
  3. How much greater are my chances of a successful procedure with adjustable sutures and doing both eyes at one time?
  4. How many muscles will you reposition in each eye?
  5. How long will the actual procedure take? (about one hour for me for one eye).
  6. What is the recovery time with adjustable and fixed sutures? (Adjustable will take longer with some discomfort,) and how long will I be out work or school? (In my case, I went to work two days later, but I am the boss and have a desk job.)
  7. Do you use the same anesthesiologist for all your strabismus procedures?
  8. What do you consider a successful procedure (How many diopters deviation and no double vision?)

You may have other questions, but the above are the most important in my mind.

In my case, in 2005, the surgeon scared me out of it with her recommendation of having to do both eyes, possible infection, over-under correction, and double vision, along with the possible complication due to scaring from a similar 1956 procedure. So I procrastinated until 2008. When all this possible negative stuff comes out, remember that this procedure has been around since the 1950’s (I had my first one in 1956 in France), so it is very common by now.

George Alexanian’s “Suggested list of questions for your strabismus surgeon” is Copyright by George Alexanian and Eyes Apart, and may not be used without written permission.

George has been helping people at Eyes Apart for a bunch of years now. We appreciate him so much. George “adopted” the My Strabismus Surgery area of Eyes Apart and provides excellent support for those considering or recovering from surgery. George also helps people via our email support group.

You can click the “older comments” link at the bottom of the My Strabismus Surgery page to see more comments, including George’s very helpful and encouraging responses through the years. Thank you, George, for all you do!

13 thoughts on “Suggested list of questions for your strabismus surgeon”

  1. Anne, our group is hosted by Yahoo Groups. Click the link near the top of George’s suggested list of questions above, and follow the instructions to create a Yahoo! login or sign in if you already have a Yahoo login. If Yahoo doesn’t return you to the Eyes Apart support group at Yahoo, come back to this page and click the link again after you’ve created your Yahoo! login and signed in. Then click “Join this group” at the Eyes Apart Strabismus Support home page.

    That is the best way to do it, because you can set your preferences at our group website and change them whenever you wish. Please see if that works for you and, if not email me via “Contact” on the blue menu bar at the top of this site and I’ll help you.

  2. Hello. My name is Frances. I just woke up this morning after a massive and excruciating migraine in the right eye that I thought, “google must have some answers if my surgeon doesn’t. I can’t seem to get rid of the pain when it comes with any medication. I cry and even scream because of the worsening pain. My third surgery was a year ago. My eyes have good alignment but the migraines wont go away. Only on one rare occasion did the migraine pass to the left side. I am going to go see a neurologist only because the doctor who operated on me became defensive when I tried to explain that the migraines might be correlated with the surgery. The migraines come and go but the pain level has increased over the past year. I do believe stress is related to the pain but not entirely.

  3. I have had several surgeries on both eyes; original diagnosis was Brown’s, now I have deviations in both eyes. I did well after a certain surgery, but was convinced to continue. My primary surgeon passed. Key to success is the proper surgeon. Knowing this, do you have a list of qualified strabismus surgeons? I have also had upper eye lid surgery and ptosis repair. I still need a secondary ptosis surgery.

    Feeling optimistic that, even the age of 42, I might be able to be helped. And I don’t feel so isolated in my endeavor.

  4. I had not looked at this particular site in a long time. I considered having people put up good surgeon recommendations over various parts of the country, but I thought that might lead to blame if something goes wrong.

  5. Great list of Questions, George! We also have How long will my eyes remain red after the procedure? as another very common question by patients about to undergo Squint Surgery. Continue the great work, Eyesapart.

  6. I had strabismus surgery two days ago.i have double vision but it can be resolved if I shut off the vision in either of my eyes. I’m wondering should I try not to mentally suppress the double vision in the hips that the two images may eventually align?

  7. Hello Paul! If you didn’t have double vision before surgery, and it has only been two days, that is not unusual. Surgeons usually over-correct a little to compensate for the tendency for the eyes to move back toward their original position. The surgeon usually gets as close as he can to the amount he or she estimates the eyes are likely to drift back. Then when they do move back, the hope is that they will be closer to perfect alignment. That said, do ask your doctor about the double vision. your doctor is the one who knows whether this is normal for the amount of correction done in your case. You can also join our Eyes Apart Strabismus Support email group at Yahoo. Just click the purple Yahoo box at the top of this page. Lots of people in our group have had surgery and will offer support and help and maybe even share experiences. I hope it all goes well for you!

  8. I have intermittent exotropia which I have had from birth. I believe it was inherited from my mother since she has it as well. I have never had surgery although it was suggested by a doctor to my parents when I was younger. My eyes were much worse then.

    However, I have been able to improve my vision to the point where the exotropia is barely noticeable. I took vision therapy for a few years. I also have my own vision therapy program (computerized) that I work on everyday at home that I purchased from my doctor. This improved my vision to the point where both of my eyes work perfect together close up. The exotropia only presents itself occasionally when i look off into the distance. There are some other things you can do if you don’t want to do surgery, cant afford it or even if you have already had surgery.

    1- Limit how much time you spend at the computer. If you must spend more than a few hours. Get up and take frequent breaks and stretch your eyes. You can even get special glasses designed for people who work at the computer for long periods of time that help to reduce eyestrain. (I have them and they help tremendously)

    2- Watch your diet. Eat alot of vegetables, fruits and lean meats. Avoid sugar and fatty foods. I notice my eyes tend to be worse when I eat bad.

    3- Look into vision therapy. However it is very expensive. But if you can’t afford to do it. There are programs that you can get from your doctor that you can do at home in your own spare time.

    4-Wear protective sunglasses or eyeglasses particularly when you are out in the sun.

    5- Get plenty of sleep. My eyes tend to be worse when I don’t get enough rest and relaxation.

    7- If you wear glasses, take some clear tape and put it on the outer corners of both of the lenses. That has helped me to train my eyes to stay focus and work together without drifting. ( I have 2 pairs of glasses and use the ones with clear tape only when Im at home.)

    6- There are some exercises out there that you can find and do for free online that are very helpful. The Brock string exercise is one of the best at helping to train your eyes to work together. In addition its very easy to make. In fact you can find the items needed probably at a local store nearby you. You can do this exercise several times a day. It helps with training both of the eyes to work together. Hope this helps someone,

    Good Luck,

  9. Thanks for the tips Michelle! They are great. I suggest anyone using vision therapy helps found online be sure to check with their personal vision therapy doctor first to make sure it is right for their specified need. If you have used similar exercises in therapy to what you find online, they would probably be fine. I would think brock strings would be fine for most cases of strabismus also, but I suggest you try vision therapy under the supervision of a COVD approved Developmental Optometrist to see what is recommended for you before you start prescribing your own therapy.

    I love the clear tape lenses. The doctor who did my vision therapy fixed a pair of glasses like that for me. She carefully applied it to just the right place so it would not be too close or two far from my pupil. I have never been able to get them that perfected on my own, but even if it isn’t as close to the pupil as I like, it should help. I need to do that again.

  10. Hildah, there is a drop-down list on the page where you sign up for Yahoo. Click on Month and select the month of your birthday, then same For Day and for Year.

  11. Hi
    I have squint in my left eye since birth. It was operated in 2008 but not corrected properly. So I again visited surgeons but they said my squint is very less and inward so no need to operate and can be corrected by glasses. I m 25 now and vision is also very less in my left eye.I m wearing +4 glasses 24/7 but still my problem persists. Sometimes I feel very insecure about it socially. Can it be corrected by lazy eye block games available on Google play?

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