Showing posts with label Surgery. Show all posts

Squint - Surgery

Surgery-Squint

Surgery to correct a squint may be recommended if other treatments are not suitable or do not help.

The operation involves moving the muscles that control eye movement so that the eyes line up better.

Preparing for squint surgery

Before surgery:

you'll attend a pre-operative assessment – some simple tests will be done to check that you can have the operation and you'll have the chance to ask any questions about it
you'll be told when to come into hospital for the procedure and when you should stop eating and drinking beforehand
you'll need to sort out how you'll be getting home – you can usually go home the same day, ideally with a friend or family member to escort you (as you may be sleepy); you won't be able to drive for at least a day or two if you've had surgery

What happens during squint surgery

Squint surgery is done under general anaesthetic (where you're asleep) and usually takes less than an hour. You or your child can usually go home the same day.

If your child is having surgery, you'll be able to accompany them into the operating room and stay with them until they've been given the anaesthetic.

During the procedure:

the eye is held open using an instrument called a lid speculum – sometimes it may be necessary to operate on both eyes to get the alignment right
the surgeon detaches part of the muscle connected to the eye and moves it into a new position so that the eyes point in the same direction
the muscles are fixed in their new position with dissolvable stitches – these are hidden behind the eye so you won't be able to see them afterwards

Sometimes, in adults and teenagers, further adjustments to your eye muscles may be made when you've woken up after the operation. Local anaesthetic eyedrops are used to numb your eyes for this.

After squint surgery

Following the operation, a pad may be put over the treated eye. This is usually removed the next day, or sometimes before you go home.

The eye is likely to be sore for at least a few days. You may be given painkillers to reduce discomfort and some eyedrops to help with healing.

You may experience some of the following side effects:

eye pain – this tends to last at least a few days and often feels like grit or sand in the eye; taking simple painkillers such as paracetamol can help, although children under 16 shouldn't be given aspirin
red eyes – this can last for a couple of months; you may also have blood in your tears for a day or two
itchy eyes – this is caused by the stitches and it may last a few weeks until they dissolve; try not to rub your eyes
double vision – this usually passes after a week or so, but can last longer

You'll be asked to attend follow-up visits with an eye specialist after surgery. Contact them, the hospital or your GP if you have any severe or lasting side effects from surgery.

Returning to normal activities

It can take several weeks to fully recover from squint surgery.

Your doctor or care team can give you specific advice about when you can return to your normal activities, but generally speaking:

you can read or watch TV and carry out other daily activities as soon as you feel able to
you can return to work or school after about a week
do not drive for at least a day or two (as the anaesthetic may not have fully worn off), or for longer if you have double vision
try not to get any soap or shampoo in the eye when washing
most people return to exercise and sport after about a week, although you may asked to avoid swimming and contact sports (such as rugby) for 2 to 4 weeks
do not use make-up close to the eyes for 4 weeks
your child should not play in sand or use face paint for 2 weeks

If you wore glasses before surgery, you'll probably still need to wear them. But do not wear contact lenses until you're told it's safe to do so.

Risks of squint surgery

As with any kind of operation, there's a risk of complications after surgery to fix a squint. Serious complications are estimated to occur in 2 to 3 in every 1,000 procedures.

Risks include:

further surgery being needed to fully correct the squint – this is quite common, particularly if the squint is severe
permanent double vision – this may require special glasses to correct your vision (read more about how double vision is treated)
an infection, abscess (build-up of pus) or cyst (build-up of fluid) around the eye – this may require treatment with antibioticsand/or a procedure to drain the pus or fluid
the eye muscles slipping out of position – further surgery may be needed to correct this
a small hole being made in the eye as the eye muscles are stitched in place – this may require antibiotics to prevent infection and a procedure to close the hole
loss of vision – this is very rare

Speak to your surgeon about the risks of surgery before the operation.

Childhood squint

Learn about the causes of squints, a misalignment of the eye, including the symptoms and the treatment options.

Perforated eardrum - Surgery

Surgery-Perforated eardrum

You may need surgery to repair your perforated eardrum if the hole in your eardrum is large or doesn't heal in a few weeks

The type of operation you'll have is called a myringoplasty.

What happens during surgery for a perforated eardrum

Surgery to repair a burst eardrum is usually carried out in hospital under general anaesthetic (where you're asleep).

During the procedure:

a small cut is made just in front or behind your ear and a small piece of tissue is removed from under your skin – this will leave a small scar, which will usually be covered by your hair
small surgical instruments are used to patch the hole in your eardrum with this piece of tissue – this may be done through your ear opening, or through a small cut made next to your ear
a dressing is placed in your ear to hold the patch in place and stop water and germs getting in – this usually stays in place for about two or three weeks
cotton wool padding is put over your ear and held in place with a bandage
the cut(s) in your skin are closed with stitches

Most people can go home on the same day or the day after the operation.

Recovering from surgery for a perforated eardrum

It usually takes a few weeks for your eardrum to heal.

A follow-up appointment for about two or three weeks after your operation will be arranged before or soon after leaving hospital.

Looking after yourself

After the operation:

make sure someone stays with you for the first 24 hours – don't drive or drink alcohol during this time
change the cotton wool in your ear every day (but leave the dressing that's deeper in your ear in place)
avoid getting your ear wet – place cotton wool covered in petroleum jelly (such as Vaseline) in your ear when showering
you may need to stay off work (or school) for about a week – you might be off for longer if your job involves lots of moving or bending over
after about a week, speak to your GP surgery about getting your stitches removed (if they don't dissolve by themselves)

Activities to avoid

Until you've had your follow-up appointment, avoid:

flying – read more about flying with a perforated eardrum
swimming
smoking
close contact with sick people – you could pick up an ear infection
sports and other strenuous activities
blowing your nose too hard – if you need to sneeze, try to keep your mouth open to reduce the pressure in your ear

Your doctor or nurse will advise you when to return to normal activities.

When to get medical advice

It's normal to have some discomfort, dizziness,unusual noises in your ear and a little bleeding for the first few days after surgery.

Contact the hospital or your GP if:

you have lots of fluid or blood coming from your ear, particularly if the fluid smells bad
you have pain that's severe and isn't relieved with painkillers
you feel very dizzy or the dizziness doesn't improve in a few days
your ear is red, swollen and itchy

Risks of surgery for a perforated eardrum

Surgery to repair a perforated eardrum doesn't usually cause any serious problems.

But possible risks include:

a wound infection, which can cause pain, bleeding and leaking of fluid – contact the hospital or your GP if you have these symptoms
ringing or buzzing in your ear (tinnitus) – this usually improves in time, but can sometimes be permanent
changes in taste – these are usually temporary, but can occasionally be permanent
worse hearing or hearing loss – although permanent hearing loss is rare
inability to move muscles in part of the face – this may get better over time, but can be permanent in rare cases

Before you have surgery, talk to your surgeon about the possible benefits and risks of the operation.