Children’s squint (strabismus) surgery

A squint or strabismus is a condition where the eyes are misaligned or crossed. One eye can turn in (convergent), out (divergent), up, or down. Squints can occur in approximately three out of 100 (3%) of children.

Surgery may be recommended if there is a chance of restoring your child’s ability to use their eyes together or improving the appearance of the two eyes, and can be carried out at any age.

What does squint surgery involve?

The surgeon will open the eyelids while your child is asleep under general anaesthetic. The surgeon will not cut around the eye so there are no scars on the eyelids. On the white part of the eye (sclera) there is a layer like cling-film called the conjunctiva. When this is cut the surgeon can see the eye muscles. These muscles control the position and movement of the eyes. The surgeon will move these muscles to make them stronger or weaker.

What to expect?

On the day

Squint surgery is usually carried out under a general anaesthetic, which means your child is asleep for the surgery. Your child will usually wake up with one eye pad on, which is then taken off almost immediately after.

Most squint surgery is done as a day case operation, and usually takes about an hour. When your child is awake and has eaten and drunk and been to the toilet you will be allowed home, usually three or four hours after the operation. If children need to stay in hospital there are provisions for a parent or carer to stay with them. This will be discussed with you in more detail if necessary.

After the surgery

After the operation, some children experience a little discomfort, mainly a scratchy feeling, for a day or two, and painkillers like paracetamol are helpful. Your child will also be given eye drops to put in for a couple of weeks afterwards to help healing and to prevent infection. The white of the eye will be quite red and this will take some weeks to fully settle, gradually fading. We usually recommend about a week off school to recover, but some children are ready to return sooner. Your child can use their eyes as normal straight away. They can bath or shower next day, although we recommend they try not to get soap or water in their eyes. Light exercise is fine, however it’s usually recommended to avoid swimming for four weeks after squint surgery.

Risks of squint surgery

Complications from squint surgery are rare, but may include over or under-correction of the squint, double vision or very rarely an infection or inflammatory reaction which would need further treatment. In rare cases, a further operation may be needed if, for example, the muscle were to slip. The risk to your child’s sight is minimal (approx one in 10,000) as the surgeon does not go inside the eye itself.

Some patients require more than one operation before their eyes appear straight – this is quite common if the squint is severe.

A general anaesthetic carries a very slight risk of complications.