qa20

Question

I had strabismus surgery when I was 4 to correct esotropia,and didn't have any further problems until Jan.97, when I was 42. My right eye,which is also amblyotic started giving me problems and causing headaches and very bad eye strain. I went to several drs. before finally convincing them that I had an eye problem,not a neurological problem. I finally found an expert in this problem in adults in April. Had surgery in May. They operated on my "good" left eye, because my right had been corrected as much as possible when I was a child and it would have been too dangerous to move the muscles over further. A couple days after the surgery,my right eye became exotropic and is now at the far right corner of my eye instead of crossed. My left eye which was operated on is also a bit exotropic. I am scheduled to have surgery again next month - this time to recess a musscle on the right eye. I've been around and around with this for almost two years and am really at my wits end with this problem. How realistic is it to believe that my eyes will ever be back to some semblance of normal at my age? I'd be very interested in your thoughts on this matter. Thanks.

(Joyce S.)

Answer:

Dear Joyce

You seem to have an akward problem, The main question is why you had eye strain and headaches at age 42. Were you perhaps farsighted, i.e. did you need plus glasses ? If so, were these prescribed ? In that case you should have had difficulty reading.
Worse than that would be a combination of a little farsightedness and a tendency to exotropia. Curiously, because of an adaptation to squint that may occur in the brain at early age (anomalous retinal correspondence), it may even be possible that, when you maybe got reading glasses at, say, age 40, your convergent squint reduced a littlebit (remember that focusing is connected to convergence, i.e. eyes moving towards nose), but just enough to give the brain the impression you were exotropic, causing headaches and eye strain. In either case it would not be advisable to operate, but very well the diagnosis may have been totally different, so please supply some more information so we can work out this case.

(Herb Simonsz, MD, PhD)

_{Note: To contact contributors to this page, replace [AT] in the e-mail address by @.}