Question

I am contemplating surgery, and was referred to Dr. Renee Richards, from New York. I understand she is one of the best surgeons in this area and I was wondering if you've heard of her.

My left eye was operated on when I was a child, and now, at at 45, after having drifted to the left over the past years, I am considering having it straightened. Dr. Richards seem to feel that double vision would not be a problem. The operation would have to be done in two stages since three of the four main muscles were originally operated on.
She indicates that the risk is small.

What will happen to my eye if I do no have the surgery? Over the past 30+ years, it has drifted toward the outside corner. Is it possible that it could move even more? If I do have the surgery, will I be able to move my eye at all, and why isn't double vision a concern for my doctor?

Is it likely that my eye will drift again?

(Annette Kovalcik)

Answer:

Dear Annette,

You seem to be in good hands and should follow your doctor's advice. Divergent (outward) squint has a tendency to recur after surgery, possibly one third has another operation, and this risk is approximately the same for every further surgery. The estimation of the chance of double vision may be difficult, but I suspect your doctor has simulated the situation after surgery optically by means of a prism and you did not see double. Alternatively, you were able to tell your doctor that you did not have double vision when the eyes were (almost) straight years ago and then she has good reason to assume that you again will be able to suppress the image of the squinting eye although, in rare cases, an exception may occur.

Yours truly,

(Herb Simonsz, MD, PhD)

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