Your Adjustable Strabismus Operation – what to expect

Before your operation:

Preop visit:

  • Check vision – better vision will help the eyes stay together after the operation
  • Check the eye position measurements
  • Discuss any new medical health issues/medications
  • Discuss adjustable procedure
  • Discuss postop strategies, risks, answer questions

Need to do:

  • Admission forms – sign, deliver
  • Glasses – if your glasses have prisms, collect glasses with no prism for use after the operation
  • Chemist – make up antibiotic ointment, bring to hospital
  • Time off – work, no swimming for 1 month
  • Driving – no driving until you adjust to your new position

Day of op:

  • NB must be well
  • No makeup
  • Bring antibiotic ointment with you to the hospital

At the hospital:

  • Anaesthetic discussion/check
  • Anaesthetic may be general or a relaxing anaesthesia before anaesthetic is put around the eye

In theatre:

  • Bring your antibiotic ointment into theatre with you
  • Eyelids, lashes and eyes will be cleaned
  • Dr Dunlop will check both eyes
  • At the end of the operation antibiotic ointment and anaesthetic drops will be put in both eyes
  • An eye pad is put over the adjustable eye to reduce the lid rubbing on adjustable threads

In recovery:

  • The eyes will be blurry from the ointment
  • Adjustable eye is covered by eye pad
  • Dr Dunlop will give you some postop information
  • Glasses on when fully awake
  • Keep your eyes closed in the car or directly look straight ahead


  • Leave eye pad on the adjustable eye
  • Put some ointment into the other eye before going to sleep

Next day - adjustable procedure:

  • Bring your antibiotic ointment and glasses (without prisms)
  • Leave eye pad on
  • The other eye may be red and blurry from the ointment
  • You may be tired from the anaesthetic
  • Depth perception/3D vision will be different with an eye pad and if both eyes have had operation – use care on steps/stairs and pouring hot drinks

Adjustable procedure:

  • Leave eye pad on - Dr Dunlop and staff will take the pad off and put anaesthetic drops into the adjustable eye
  • Dr Dunlop will measure the new eye position several times until the eye position stabilises. The brain needs to learn the new eye positions. This takes a while after the eye pad has been removed.
  • You will have lots of anaesthetic drops. You will feel the threads on the eyelashes but nothing sharp.
  • It sometimes feels like an ache if the muscle needs to be moved.
  • Dr Dunlop will put a cover over the eyelashes and hold the eyelids open. It takes a while to find all the hidden threads. Lots of anaesthetic drops are used during the procedure. Usually measurements are checked during the procedure. This means you will have to sit up and lie down several times.
  • Once the measurements are satisfactory, the threads are tied.
  • At the end of the procedure, antibiotic ointment is put into the eye. This also helps to lubricate the surface/wound from the lid movement. When you go home you will have both eyes open, (but blurry), using your glasses (without prisms). It is wise to have a quiet day. As it was an afternoon operation, some anaesthetic may still be present, making you tired.

Postop period:

  • Put some antibiotic ointment into the operated eye/s three times a day and a little more whenever eye/s feel uncomfortable. This will lubricate the surface and reduce irritation/tearing. See postop medication sheet. Lubricating drops are helpful later.
  • Glasses on – this will keep the vision clearer, helping the brain to learn to put the eyes/vision together
  • Eye exercises – the operation has loosened the muscles. Stretch eye exercises prevent tightening of the muscles again
  • Eye position – this will vary while the eyes heal

Glasses check:

  • Dr Dunlop will recheck the eye refraction measurements 4-6 weeks postop. Clear vision is important to keep the eyes aligned.


  • Vision – if the vision is not clear the eyes may turn. The glasses need to be kept up-to- date. Cataracts can blur the vision or cause glare, making it harder to control the eye position.
  • Eye muscles – continue stretch eye exercises to stop tightening of the muscles.
  • Further operations may be required.