What are the indications for surgery in patients with IDEX? How is surgery performed and what are the complications?
Video Transcript:
The eyes are straightened by either weakening the outside muscle of both eyes, or weakening the outside muscle and strengthening the inside muscle of one eye.
Most surgeons aim to leave the eyes very slightly turned inwards (less than 5 degrees) immediately after the surgery. It is not uncommon for children to experience some double vision in the first 1-2 weeks following surgery, but this usually resolves as the eyes move outwards to a straight position.
What are the complications of surgery?
- - Over correction
If the eyes remain more than 5 degrees turned inwards 3-4 weeks after surgery glasses with a small prism can be prescribed to straighten the eyes. If after 2 months the eyes are still turned inwards (this occurs in fewer than 5% of children) further treatment, in the form of either botox treatment to the inner muscle of the eye or further surgery will be required.
- - Under correction
A slight under correction is a common finding following surgery for an intermittent exotropia. This small squint can be detected by the Orthoptist in the clinic, but is not normally noticeable to the child or their parents. As long as the child is maintaining good binocular vision and the angle of the squint remains stable no further surgery will be needed.
