[laura1701]

#1060679

I am scheduled to have strabismus surgery on both of my eyes on January 20, 2016. My surgeon uses adjustable sutures. What will I need during this recovery? I am hoping this will be much less of a big deal than the OD???

I had an OD on my right eye July 2015. I found the recovery from the OD long, difficult and so very painful, but it was worth it in the end because it saved the vision in my right eye. I had a wonderful surgeon. I have severe double vision as a result of the OD, but I was somewhat prepared for that. I have been dealing with varying degrees of double vision since 2011. To all you fellow TED sufferers – I applaud your patience and strength for getting through this unbelievably uncomfortable and trying aspect of Graves. I turn to this forum when I find myself about to go insane with some aspect of this TED journey! I have found lots of info here on recovery from OD – THANK YOU so much to all who shared their experiences! It was a great help to me. I put all of your advice to good use! I am not able to find much about experiences with recovery from strabismus surgery. I am very curious about what to expect. Please share.

[snelsen]

#1184088

Hi Laura,

You’ll have to look for it, but I described my OD and my strabismus surgery. I remember that the strabismus surgery was a DREAM!!! Easy peasy! Went out for lunch. No big deal to have the adjustable sutures. Sometimes they are needed, sometimes not. I found to be LIfE CHANGING, in the most marvelous
and positive way I can describe. Even in the operating room they woke me up to look at objects across the room, and I saw ONLY ONE OBJECT, contrary to the horrible double vision I had for a long long time. I had both done at once,that is fine.

The hardest part of TED was waiting to have the strabismus surgery.

I also found my one OD a very difficult post op experience. Only good thing about is, that it really did save my vision. There was a huge amount of pressure on my optic nerve. To relieve the pressure, I did have IV steroids.

So, I have nothing negative to say, and all is enthusiastic and wonderful.
Shirley

[scanders]

#1184089

Another point of view. First, the end of result of the strabismus surgery is better than I was led to believe it would be. (But then, maybe they tell us that so we don’t get our hopes up?) I don’t have a prism at the moment, and on some days can even wear contacts. Unless I’m really tired, I pretty much have single vision, at least straight ahead. Before surgery I wasn’t even able to use a prism, so had a lens of my glasses occluded. So yes, this was a life changing event.

I had bilateral muscle surgery in January, with an adjustable suture in my right eye, and four muscles moved in total. I’d had bilateral OD the September before. My experience was the opposite of many, apparently. My OD was done endoscopically and that recovery was pretty uneventful from a comfort standpoint. I don’t know if it was the surgical approach used, or the relief of the pre-surgical pain/pressure? But the strabismus surgery was a different story. I’d read many accounts of how easy and relatively painless the recovery was, so I was a little unprepared for how uncomfortable my recovery was. (The surgeon did say I had one of the toughest Graves muscles he’s ever worked on.) It hurt on the surface, it hurt deep when I moved my eyes to focus, the sutures were even noticeable (they felt big and scratchy) for a longer time than I thought I would feel them. Not to worry you, because again, the end result has been so worth it! But I think it bears mentioning that there could be some discomfort. (I don’t consider myself wimpy–I just didn’t do my homework as well as I should have.) I have noticed that it seems those that had a more difficult course after the OD seem to report a better experience after the muscle surgery, so hopefully that will be the case for you!

[snelsen]

#1184090

Hi scanders!

Nice to hear from you!

I love this forum!

Shirley

[laura1701]

#1184091

Thank you for your responses. Any specific advice for dealing with the possible scratchy sutures and the pain? Did you ice, take pain meds, use eye drops? Did you have swelling like with an OD? Could you watch TV or read or is it uncomfortable to use your eyes for awhile? I totally understand what you mean when you described the eye pain from surface irritation and the deep pain from trying to see-that sounds like my experience after the OD. Seeing well and comfortably used to just happen without effort or thinking and with TED it is a constant effort.

[scanders]

#1184092

I could watch TV and read, but I think at first I was pretty light sensitive or something, so I was a little limited. I think I was using ice. I still had my lens occluded initially, and I was driving after a few days. I spent as much time as I could, however, with my eye uncovered trying to fuse. I did learn pretty quickly not to move my eyes quickly, if that makes sense, to avoid the shooting pain. I’d say that was improved a lot in 4-6 weeks. I initially had an antibiotic eye ointment prescribed, and I could use eye drops for lubrication. I also used eye ointment at night for lubrication (still do) when the course of prescription eye ointment was done. I finally called the surgeon to ask how much longer I could expect the scratchy feeling from the sutures, because if I knew how much longer, I thought I could tough it out since it had to be close to time for that last one to dissolve. He told me to use the tobramycin ointment again, and sure enough, that helped a lot in a day or so. That was maybe at 6-7 weeks? So I wish I hadn’t been trying to be so “brave”, because if I’d asked sooner about how long to expect the suture discomfort, I could have had the advice sooner about the ointment and alleviated some pain. The lubrication ointment wasn’t enough. (We don’t know what we don’t know. I’d never had much wrong with me before Graves and TED.) I opted not to have anything stronger than extra strength Tylenol–but I made that decision while I was still under the influence of the anesthetic. In hindsight, probably not my brightest move. I toughed it out with the Tylenol. I had surgery on Thursday, and went back to work on Tuesday. Not enough time, I think, although who knows? Again, many people report needing very little down time, and not really needing pain meds, and hopefully you’ll be one of them!

[laura1701]

#1184093

Scanders-Thank you so very much for your detailed response! I am hoping a few more people will chime in, but you have given me a clear picture of what I might expect. I am mentally planning for a easy recovery, but will also be prepared for one that is less so! I cannot believe you went back to work so quickly. I have used glasses with an occluded lens as well and yes, I understand the pain with eye movement thing. At times, it just hurts to use my eyes! I am thinking that none of my present glasses or temp prisms will be of use, because hopefully they will be way too much correction-I am thinking about the transient period after the surgery? Could you see single vision shortly after surgery? Did that fluctuate a lot during the healing period?

[scanders]

#1184094

I guess that depends on what you mean by “shortly”? I seem to recall I just gradually had more periods of single vision, and by about 4 weeks, I think, I had more single than double. But I worked at it, spending time each day “fusing”. They didn’t suggest even looking at prismatic correction until I was at least 3 months out because of the constant changes while healing, and then, surprisingly (according to the doc), I didn’t need it.
I still have convergence insufficiency up close. There are exercises for that–they just didn’t work for me. I think I’ve adapted for the most part, and I could always get a bit of prism for reading if I want at some point.

Like I said before, I wished I’d done my homework as you’re doing so I would have been better prepared, but given the outcome, no regrets!

[snelsen]

#1184095

Maybe it is because the multiple months of double vision was so hellish, and I had to wait for such a long time after the OD, to be sure my eyes were before the strabismus surgery. But my experience was very different from sanders, as noted above.
To focus on your specific questions….
1. I did not have the scratchy feeling sanders experienced.
2. I had the procedure in the morning, walked around a lake, 3 miles, the same day.
3. Yes to lubricant and eye drops.
4. I did not have to have any adjustment to the sutures.
5. I have been light sensitive since TED began, and MUST have fit-over sunglasses handy at all times, to this day.
6. With double vision before the strabismus surgery, it was very painful to move my eyes. Looking down at the floor was the only thing I could do without pain.
7. I had no pain after the surgery. Just a very mild, scratchy discomfort which was managed pretty well by ointment. I also had an antibiotic ointment initially.
8. I used no pain meds at all. I was euphoric, cause the double vision was gone!
Shirley

[laura1701]

#1184096

Thanks again to you both for all the info you have so generously shared! “Hellish” is such an apt way to describe the double vision. I am really struggling with the unknown aspect of the recovery from eye muscle surgery. I just DREAD possibly having any lengthy stretch of time with uncorrectable double vision while the eye muscles heal. I have found it such a challenge, when I have not been able to function outside of my home. Either because my vision was so impaired at different times over the last five years and for awhile after the OD. I was overjoyed when I finally got some new glasses that worked after about 6 weeks of healing from OD! It was like being let out of a cage! Even recently I went around with headaches and such bad double vision I just had to cover one eye. I find the lens occlusion very uncomfortable-so not my favorite. It took me acouple of weeks to realize that my ground in prisms and temp prisms had slowly become over corrective!! At least my eye muscles seem to be moving in the right direction. I got new prescription with a little less vertical and a less strong Fresnel and I am mostly OK with the glasses on. As you have both experienced – I am struggling with the less functional version of myself, all the limitations DV imposes and the prospect of a few more backwards steps to move forward. Thanks to you two- I am now reminding myself that my eyeballs do see (thanks to steroids and OD) -just not together AND a few more weeks or months of pain and suffering with this will hopefully evolve into a single vision outcome!!

[scanders]

#1184097

I’d sure agree with the “hellish” descriptor! But just wait until it’s done! A whole new world! I have to say that my period with the double vision was probably the only “dark” time I’ve had in my life. (I look back and have no idea how I was driving, even with the lens occluded…lucky I didn’t hurt anyone…) Anyway, it’s just so amazing, now I feel as if “the light is back”, if that makes sense. It was so worth it! Best of luck!

[jeff92]

#1184098

Such an inspiring message, as always thank you for sharing your journey with all of us. My wife was recently seen for strabismus surgery and found out that this dr had peel and stick prisms that could help with the double vision. We wished we had known about these sooner so I wanted to post this to the group. They are not perfect but do help with seeing for at least part of the day.

snelsen wrote:

Hi Laura,

You’ll have to look for it, but I described my OD and my strabismus surgery. I remember that the strabismus surgery was a DREAM!!! Easy peasy! Went out for lunch. No big deal to have the adjustable sutures. Sometimes they are needed, sometimes not. I found to be LIfE CHANGING, in the most marvelous
and positive way I can describe. Even in the operating room they woke me up to look at objects across the room, and I saw ONLY ONE OBJECT, contrary to the horrible double vision I had for a long long time. I had both done at once,that is fine.

The hardest part of TED was waiting to have the strabismus surgery.

I also found my one OD a very difficult post op experience. Only good thing about is, that it really did save my vision. There was a huge amount of pressure on my optic nerve. To relieve the pressure, I did have IV steroids.

So, I have nothing negative to say, and all is enthusiastic and wonderful.
Shirley

[Liz1967]

#1184099

I am scheduled for strabismus surgery at Kellogg Eye at the end of February. My bilateral ODs were not painful, but the double vision got a lot worse. It has since improved to just a few diopters from where I was before surgery. I had the lid retraction corrected before the strabismus surgery, which I had always heard was out of order, but turned out to be a real game changer in a positive way. Eyes so much more comfortable. As Fresnel prism is working for me, I am also very nervous about the strabismus surgery, even though I am having it done at a center that specializes in Graves eye disease. I totally understand what you are saying, Laura. I am functional now and I hate to mess that up even temporarily. I have waited so long to have the surgery, and now I am terrified it won’t work or will make my eyes uncomfortable again.

[laura1701]

#1184100

Liz-My strabismus surgery is also at Kellogg Eye Center next week! The weather is supposed to be really cold while I am up there. I live in the Deep South, so will be a big change for us! I am down to using one eye at a time now-so a pirate patch or my glasses with one lens occluded with 2 layers of clear contact paper. Too much strain on my neck and eyes to keep trying to use both eyes together this last week or 2. I am actually looking forward to this surgery or really to the outcome of this surgery. I too dread the discomfort to get to the outcome. It is hard to willingly rock the boat isn’t it? Maybe this one will be easy for both of us-like it was for Shirley! How long between your ODs and the strabismus surgery for you? I am doing the Saran Wrap over the eyes at night for lid retraction. My lid retraction is not too bad now, but still causes dry eye problems. They will evaluate for lid retraction surgery after I heal from the strabismus surgery or maybe I will just continue to Saran Wrap my eyes for the rest of my life!!

Jeff-I have been wearing a combo of varying strength fresnel temp prisms for horizontal correction and the vertical correction is ground into my lenses. Fresnel is only on one lens. I asked my local optometrist to order the fresnel prisms for me. I live in a small town so they are not normal offerings from the eye docs here. I got my first fresnel from an orthoptist in a larger city eye clinic.

Thanks again to everyone for sharing their experiences!

[snelsen]

#1184101

I know I have said it before, but strabismus surgery a piece of cake! Really.
My OD was very difficult.

After strabismus surgery, I went out for lunch, and walked a mile with a friend.
Shirley

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