Strabismus (squint) surgery for "cosmetic reasons" (child)?

[NicksCurtis]

My DS has a mild strabismus (squint). He has been under the care of Moorfields for quite a long time, where he goes every few months for them to check his eyesight. His eyesight is actually great, but the squint is still there but controlled by him pretty well. I took him to a behavioral optometrist who suggested prisms, but the consultant at Moorfields was against them (can cause additional problems, apparently.)

Anyway, he is now 9, and we are trying to decide whether to do the surgery. It won't have any (positive) effect on his eyesight it seems. But it will, if successful, improve it cosmetically. It is not bad, but if you are paying attention, you do notice. So on the one hand, it would be great to have it sorted -- but on the other hand, why risk eye surgery?

Consultants are vague -- up to us, they say! We have another appointment soon so I'm trying to prep for it.

Any thoughts from anyone who has been through this? Thanks!

Not been through it but would definitely have it done.

I would do it. I know someone who had it done in his 30s and would have preferred to have it over and done with much earlier.

Both of my children have had the surgery! DS was 2 and DD was 7. DS worked perfectly but with DD it was only for cosmetic reasons. Consultant said it was 50/50 chance it would work. It didn't fully work but definitely better.

I recommend it. It was uncomfortable the first day but it was okay after that. DS was out by 10am, had some morphine because he was very upset and slept until 4pm! We went home at 5pm and he still slept that night!

I'm sorry to hear of what you you have gone through with your son's eyesight, it's hard having to process all these decisions as a parent isn't it!
So I only have eyesight in one eye. It doesn't affect me as such as I was born like this. The eye moves about fine and doesn't cause any reason issues, however, I had a squint in that eye. The eye moves upwards when I'm tired or if my eye is soar. I've been told that because it doesn't work the muscles aren't as strong and that causes the squint.
There is surgery to fix it, but it is a completely cosmetic thing. I'll never be able to see out of that eye (this is fine!!).

I don't think this was ever offered to my parents, maybe it was, but I've never had any treatment to help with the squint.

I can't tell you what my eye has done to my self confidence over the years. I have been concious of it for as long as I remember being alive. Even in early primary school and even more so as I've got older. A lot of people wouldn't notice it, but whenever I'm photographed or look in the mirror it's all o can see.

I used to wear a fringe over my eye, only have my photo taken from one side, completely avoid eye contact on all occasions.... it really bothered me. I rarelt talked to anyone about it because everyone would just say it was nothing.

Even as an adult I hate my eye and I'll still avoid eye contact. Like I said earlier, people say they don't even notice it.... but it doesn't change it.

I honestly believe that had this been corrected as a child, it would have avoided years of self consciousness. Who knows, maybe I would've been a more confident person.

There's nothing wrong for doing things for cosmetic reason. If it isn't going to harm your son and has no risks, then I would go for it.

I'm actually going to have mine corrected soon. I mentioned it at the eye hospital a few months ago on an appointment and just like that they have offered me corrective surgery! Like your son, I'll have no benifit to my vision but I can't wait to feel like my eyes are normal ☺️

We have been through this and had it done and would 100% do so again, no question. Cosmetic reasons are very genuine reasons and rightly or wrongly an eye turn is so massively stigmatised and has such an association with other disabilities that I would not send a child through life with it if I had another option. The surgery is minor and a day case. Not pleasant, no, but most normal activities can resume within the week.

It can’t easily be described as purely cosmetic as it will improve the way the eyes move and work together which improves 3D vision and depth perception and the biggest improvements are seen in children, so this can’t be improved as much or at all by waiting to operate when they are older. From personal experience it can also improve relationships, which you don’t realise rely so much on eye contact and reading facial expressions until that is harder to do. Of course, I didn’t have any trouble relating to my child’s face as it was and making eye contact, but others did - especially those with autism and processing issues of their own.

We’re in the same boat and have decided to leave it up to my child. If they want it done then we will do but I’m teaching them to love themselves. They might change their mind but some friends of mine who are both doctors themselves had it done for their son and told me how traumatic it was seeing his eyes bleeding.

so yeah….if doctors are horrified then if they want the op they can decide themselves.

As of right now my child doesn’t want the surgery. So we shall just wait and see but I won’t force it on them. However if they changed their mind I wouldn’t hesitate to do it.

I have a squint that they tried to correct as a child by wearing patches over the eye. You can only see it when I'm very tired ( I hope). I am conscious of it.
There was no option of a operation when I was a child, but if my child was in this position now I would definitely allow the operation.

Similar here too, DS is almost 8 and we've left it for him to decide. It wouldn't affect his vision, and in our case wasn't guaranteed to improve how it looked, so for now we've not been keen.

I'm also a doctor and while I have seen squint surgery and don't find it horrifying, it's not something that I'd want to put him through if I wasn't sure.

I am in the same situation and have declined the surgery for now because they said one of the risks is it makes the squint much worse. Have they gone through the risks with you? It might be specific to my DD's squint because hers is intermittent but they said the surgery sometimes causes it to be permanently turned inwards instead. They are altering the muscle tension so it's not always predictable how the eye responds. I can't take the risk but if she wanted it in future I'd look into it again.

I had squint surgery in the 60’s when pretty much every kid with a squint had the op.
My squint was bad and I’m really glad I had it fixed.
My dd has a mild squint and surgery was not an option for her. It’s only noticeable if she’s very tired, had a couple of drinks or if she’s close up focusing on you - not very often that that happens.
Given the option, my dd would have had the surgery as a child but I’m not sure if she would as an adult.

Wow, thanks everyone! Still confused! I really do have to ask the consultant more about the risks as I do fear permanent damage. But I also am tempted to just get it over with. Aargh!

My child (8) had this recently for cosmetic purposes. It's worked perfectly. I did make sure the person operating for one of the people well known for doing this surgery, I said we'd whatever date and travel to ensure this. I am really glad we had it done and although it was hard seeing the immediate distress on waking after surgery the rest has been fine. Few days of calpol and then back to normal.

Also I would think the process is easier for children now. When I had my op I was left at the hospital on the Sunday afternoon, op on Monday. Nobody told me I would wake with bandages on. As it was late when I came round I was put onto a men’s ward and was pretty scared and confused (6years old)
I also remember my Tiny Tears doll being pulled from my grasp as I was ‘going under’ and I’d been promised she would stay with me.
My parents visited on the Thursday evening and I went home by ambulance on the Friday.
This would not happen now thank goodness.

I had this surgery as a child, and so thankful I had it!

Hello,

I came across your post while going through the same dilemma. Our situation is almost exactly the same (Moorfields visits for a long time now, intermittent squint, good eyesight etc.). My DS is now 7 and the hospital is planning a discharge as his vision is stable - they tell us we should contact them when we are ready for the surgery. Apart from having a petrified mother, DS is also struggling a lot with tolerating the eye drops and I can’t imagine having to apply those 3-4 times a day after the surgery.

If you see this, I would be keen to hear what did you decide in the end.

Thanks so much!

My ds has this surgery when he was 8. As others say, painful for a day or so, but very manageable.

It did improve his squint cosmetically, but an ed psyche apt when he was 10 revealed a significant visual processing disorder. His brain works much faster than his eyes. We saw an optometrist who prescribed eye exercises and prism glasses which have helped a lot.

Hi -- we still haven't decided! Last appt I asked the consultant squarely: would you do this for your child? And he very definitely said no, since it wasn't that bad. I'm still unsure, but I asked that she not be discharged because last time when she was it took absolute ages to get back into Moorfields!

So no advice as to the surgery, but I would not let them discharge you or if they have, instantly get back on the list. One of the orthopists also told me that you can choose any consultant in the country to do the surgery (could this be right?) though I wouldn't have any real means of knowing who was the best!

I had it done when I was about 10. It made my squint disappear when I have my glasses on and most of the time it only gets bad when I am tired and not wearing my specs

go for it - I hated being called squinty mcginty at primary

Definitely do it, I had both my eyes done when a toddler and then another op when I was 12 at Moorfields, but I still get issues now with muscles and my eye wanders when tired and people notice, so please do it. I hate the comments and am apparently all grown up (44)

I wonder how bad it would be if I didn’t have the op at 12. Eye drops aren’t too bad, just take getting used too.