Double vision from strabismus surgery

Discussion in 'Laser Eye Surgery' started by Crispy Fish, Apr 1, 2004.

  1. Crispy Fish

    Crispy Fish Guest

    Hi all,

    Since birth, I've had scarring on my left retina from toxoplasmosis. I have
    some peripheral vision remaining in the eye, but can't see well enough to
    read, for example. This also resulted in my left eye turning outward --
    enough that people sometimes had a hard time knowing where I was looking.

    A week ago I had eye muscle surgery to correct the turn, and since then I've
    been experiencing double vision. I can get around okay and can read, etc,
    but the double vision is still disorienting and very frustrating. I would
    not trust my vision to drive a car at this point.

    I'm very pleased to have straight eyes, but how long should I expect the
    double vision to last? If it doesn't go away, what options are there for

    Crispy Fish, Apr 1, 2004
  2. 1. In exotropia, the usual early postop goal is to leave it a little turned
    in, since as it heals, it tends to go out a bit - overcorrection caused
    diplopia, usually.

    2. Your system may be long-term adapted to angling out, and takes time to
    adapt to being straight. However, not everyone is able to adapt.

    3. If the overcorrection persists, or if there is diplopia just from being
    straight, prism in your glasses can help move the image over a bit and help
    the diplopia. Your ARE wearing polycarbonate glasses all the time, right?
    (for eye protection). BOTOX can also move the eye back a little to towards
    the original angle and help the diplopia, or in some cases, additional
    surgery is needed.

    David Robins, MD
    Board certified Ophthalmologist
    Pediatric and strabismus subspecialty
    Member of AAPOS
    (American Academy of Pediatric Ophthalmology and Strabismus)
    David Robins, MD, Apr 1, 2004
  3. Crispy Fish

    Crispy Fish Guest

    Thanks for your reply, David. Just a few questions in response to your

    The adaption you're referring to would be suppression in my case, right?
    Does suppression invariably lead to loss of depth perception? I had
    sufficient depth perception prior to the surgery, and I'm beginning to fear
    that I could be doing damage to my vision.
    Will prisms negate the cosmetic benefit of the surgery?

    Crispy Fish, Apr 1, 2004
  4. Supression would have been there prior to the surgery, since your eyes were
    not straight, and you weren't seeing double. I meant that you were adapted
    to the abnormal angle, and it can take a while to get used to being straight
    - often due to having "abnormal retinal correspondence" (ARC), where the
    brain has rewired corresponding areas. If your eyes weren't straight prior
    to surgery, there would have been little if any true stereoscopic vision.
    You may feel there has been a change in your adapted depth perception, and I
    don't know haw you will find it once all has healed and readapted.

    Prisms won't negate the surgery, assuming what you have it is small,
    [possibly temporary, overcorrection. Using prisms to eliminate diplopia if
    the eyes ARE straight does cause a small shift int he apparent angle of the
    eyes, but is usually not cosmetically obvious unless the are so large that
    they are undoing a lot of the surgery, but that would lead to huge prisms
    that would be unwearable anyway.
    David Robins, MD, Apr 1, 2004
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