Veronica With Four Eyes

My Experience With Decompensated Strabismus Eye Surgery

Back in December 2016, I had decompensated strabismus surgery to eliminate the need for prism in my glasses. My vision had been declining for a long time and I needed a prism of ten in each eye, plus a temporary prism of five, for a total of 25 prism. Since my eyes would just continue to need more and more prism, my ophthalmologist and I made the decision to have muscles strengthened or weakened in each of my eyes to prevent my eyes from getting worse.

What is decompensated strabismus?

Decompensated strabismus is a condition where pre-existing strabismus is aggravated by strabismus from another condition. I have had accommodative esotropia, a common form of childhood strabismus, since I was three years old. When I was fourteen, my vision went into a downward spiral. This has been attributed to the onset of Chiari Malformation, a brain condition that causes chronic pain, migraines, and strabismus.

With both my brain and eyes fighting for control of my eyes, my vision got worse than if I had one form of strabismus. Doctors had previously believed I had idiopathic vision loss. However, the diagnosis of decompensated strabismus was confirmed by my neurologist and ophthalmologist following my surgery. This is further evidence that Chiari is a factor in my vision loss, though not necessarily the cause of it.

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Why I needed eye surgery

This was not my first eye surgery. In 2008, when I was eleven years old, I had one muscle eye surgery in my left eye after I had relentless double and blurry vision following a volleyball to the eye a few months earlier. I woke up from the surgery not needing bifocals anymore and I rode a bike for the first time eight weeks later, though it’s worth noting that this didn’t last very long.

Fast forward eight years, and I’ve been in prisms for the last six years and am back in bifocals. Due to sensitivity to light, I’m wearing very dark glasses full time. I also use a blindness cane because I can’t tell the difference between flat ground and a pothole. I walked in to see my ophthalmologist of six years right before school started. The double vision was so intense and blurry that I couldn’t read anything more than three feet ahead of me.

My ophthalmologist took one look at me and said “well young lady, you’re a mess.”

He wrote me a new prescription and we started discussing the possibility of surgery to help prevent from my eyesight from getting worse. We made the final decision for surgery about three months later, after I finished my semester at college.

Preparing for eye surgery

Outside of the general anesthesia prep which includes not eating or drinking after midnight, there were a few other things I brought with me to the hospital. Because I wasn’t able to wear anything that went over my head after the surgery and I don’t like button down shirts much, I wore a stretchy tank top that I could just step into or stretch the neckline to fit. For the surgery, I was allowed to wear yoga pants and fuzzy socks in addition to a hospital gown. I received pain medication and anti-nausea medication pretty much immediately after I was taken to the preparation room. Before I knew it, I was getting the anesthesia and loudly singing “Lucy in the Sky with Diamonds,” which was embarrassing for my mom.

Waking up from the surgery

After the surgery was done, I woke up feeling no pain from my eyes, though I felt a general heaviness in my head and around me, which is normal for me when I wake up from anesthesia. I was able to eat a few crackers and a popsicle and went back to the hotel an hour after my surgery ended.

Following the surgery, I spent the rest of the day in bed and slept on a Yogibo pillow that had a pillowcase that didn’t irritate my eyes. Light hurt me a lot, but I was not really in pain from the surgery. I was able to eat pancakes later that night at a restaurant with my mom and brother. The lights over our table had to be turned off though so I could concentrate on eating.

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Instead of putting on prescription glasses, my eye doctor requested I wear reading glasses for two weeks following the surgery. This would help my eye muscles relax and help the swelling go down. Because I am sensitive to light, I went looking for a pair that were tinted, which I have linked below. While wearing them, I can read large print and see things about eighteen inches in front of my face.  With these glasses, I could easily read screens of my devices without a problem, as these are more tinted glasses than actual sunglasses.

Before getting measured for new glasses, I had to do steroid eye drops three times a day for ten days. While they were very painful, my eyes cleared up fairly quickly and I didn’t have a bloodshot look for very long. It was difficult to go outside if there was lots of pollen or pollution in the air, since my eyes were still very sensitive, but this went away after I finished the eye drops.

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What did the surgery correct?

The decompensated strabismus surgery weakened one muscle in each eye and gave me the ability to see further distance and reduce my double vision, though did not fully eliminate it. I can see about five feet directly in front of me with glasses, and I can recognize faces and text from three feet away. This was more than double of what I could see before. The surgery did not correct my limited peripheral vision, lack of depth perception, or my print disability. I also still need a tint in my glasses to help with light sensitivity and my blindness cane, but overall I feel like I have less eye strain and I’m glad to have no prism in my glasses.

My experience having eye surgery on both eyes for accommodative esotropia and decompensated strabismus related to Chiari Malformation.