Correction of Strabismus ‘cock-eye’ at GPHC

Feb 17, 2013 News

By: Romila Boodram
Strabismus also known as squint-eye or cock-eye is a condition in which the eyes are not properly aligned with each other. It typically involves a lack of coordination between the extraocular muscles, which prevents bringing the gaze of each eye to the same point in the space and preventing proper binocular vision, and which may adversely affect depth perception.
Strabismus can present as manifest (heterotropia) or latent (heterophoria) varieties and can be either a disorder of the brain in coordinating the eyes, or of the power or direction of motion of one or more of the relevant muscles moving the eye.
Strabismus is divided into paretic and non-paretic types. The paretic type is due to paralysis of one or several muscles that are responsible for natural eye movements. Non-paretic strabismus is not due to paralysis of these muscles.
According to the Georgetown Public Hospital Corporation (GPHC)’s ophthalmologist, Dr George Norton, Strabismus happens when there is a difference in the pull of the muscle particularly on the horizontal plate.
“Those muscles are supposed to pull the eye at equal strength, if one pulls more than the other, the eye will deviate in the direction of the stronger muscles,” Dr Norton explained.
To correct the eyes, one has to do strabismus surgery which basically strengthens or weakens the eye muscles, which changes the alignment of the eyes relative to each other.
The Ophthalmologist said that the eye has a skin that is called the conjunctiva. So in order to start the operation, the eye surgeon has to literally peel the eye of its skin and “localize the muscles with a muscle hook and we work from there,” Dr. Norton explained.
“The muscles are inserted on the eye ball, we weaken the stronger one by cutting it off from where it is inserted in the eye ball and implanting it back but at a distance further back, then we weaken the other one by localizing it and cutting off a piece of that muscle and make it stronger and has a result giving it more pull.”
At presently, the hospital only operates on 12 patients with strabismus in a year and this is because of the limitation of anesthetist. “We need more persons in the anesthetic department because we have four eye surgeons who can operate on more patients.”
“If in January, I see 12 patients with strabismus, then I am booked for the year. That is the reason why we need more persons in the Anesthetic Department.”
He added that in most cases they try to operate on patients before they reach two years old.
“It’s a tedious process; we try to operate on patients before they reach age two, and we try to avoid doing all of that surgery without any bleeding so we are very particular about making the right cuts and going in the right area,” Dr. Norton said, adding that the surgery could last for at least two hours.