Strabismus surgery is surgery on the eye muscles to correct crossed eyes. Both esotropia (crossed-in eyes) or exotropia (crossed-out eyes) can be corrected by surgery on the eye muscles. Generally, the decision whether to do strabismus surgery has a lot to do with how long the crossing has occurred, the amount of crossing and other factors such as the need for glasses or treatment for amblyopia (in the case of children under age 7).
Dr. Tolsma and Dr. Pletcher work together to determine which patients are the best candidates for strabismus surgery. Dr. Pletcher has over 25 years of experience in strabismus surgery with his training at Indiana University Medical Center under Dr Gene Helveston and Dr. Forest Ellis who were well known educators in pediatric and adult strabismus surgery.
The most common strabismus conditions can occur in children under age 3 with esotropia being the most common. Often, far-sighted glasses can control the eye crossing without surgery. However, sometimes eye muscle surgery is necessary to help the eyes fuse together more naturally. Intermittent exotropia and constant exotropia are also common pediatric and even adult conditions. Generally, if the outcrossing of the eyes happens over 50% of the time, eye muscle surgery is indicated. The most common strabismus surgeries performed are a bilateral medial rectus recession and a bilateral lateral rectus recession.
There are many other conditions in which the eyes are not working together including nerve palsies, Grave's disease, Duane's syndrome, decompensation of fusion and more. All of these are evaluated for the best treatment for the particular condition. Often prism in glasses is a helpful treatment instead of surgery.