Squint Surgery in Palamu — Strabismus Correction
Eye muscle surgery to correct squint (strabismus) in children and adults — performed by Dr. Dibya Prabha, MS Ophthalmology, at Palamu Neuro & Eye Care, Palamu.
What is Squint Surgery (Strabismus Surgery)?
Squint (Strabismus) Surgery is a precise procedure performed on the extraocular muscles—the tiny muscles attached to the outside of the eye that control its movement. When these muscles are unbalanced, the eyes do not align properly. During surgery, the specialist selectively weakens, strengthens, or repositions specific muscles to achieve perfect alignment. Dr. Dibya Prabha conducts thorough preoperative measurements to determine exactly which muscles require adjustment.
Why is Squint Surgery (Strabismus Surgery) Done?
- •To physically straighten crossed eyes (esotropia) or wandering eyes (exotropia) to restore normal appearance
- •To eliminate the severe double vision caused by an adult-onset squint (e.g., following a nerve palsy)
- •To restore depth perception (3D vision) by allowing both eyes to finally focus on the same target simultaneously
- •To prevent or treat Amblyopia (lazy eye) in young children by forcing the brain to use both eyes equally
How Squint Surgery (Strabismus Surgery) is Performed
- 1
Pre-operative Orthoptic Assessment
Dr. Dibya Prabha performs a detailed orthoptic evaluation measuring the angle of deviation with prisms in all nine positions of gaze, at distance and near fixation. Ocular motility (eye movement range), binocular function (fusion and stereopsis), and refractive error (cycloplegic refraction in children) are assessed. For adjustable suture cases in adults, sensory status (diplopia testing) is documented. The specific muscles to be operated on, the amount of recession or resection, and the surgical technique are planned.
- 2
Anaesthesia and Eye Preparation
For children, the procedure is performed under general anaesthesia. For cooperative adults, local anaesthesia with sedation may be an option, though GA is usually preferred. Both eyes are prepared and draped, even if surgery is planned for only one eye, because intraoperative assessment may reveal the need to operate on the fellow eye. The eye is held open with a lid speculum.
- 3
Muscle Isolation and Adjustment
A small incision is made through the conjunctiva over the muscle to be operated on. The muscle is isolated on a muscle hook, and the surrounding connective tissue is dissected. For a recession (weakening): the muscle is detached from its original insertion on the sclera, measured, and reattached further back using absorbable sutures. For a resection (strengthening): a measured segment of the muscle is removed and the shortened muscle is reattached at its original insertion point. The conjunctiva is closed with absorbable sutures.
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Intraoperative Alignment Check and Adjustable Sutures
After muscle repositioning, the eye alignment is assessed. In adjustable suture surgery (primarily for adults), the muscle is secured with a slipknot, the conjunctiva is loosely closed, and the patient is awakened enough to cooperate with alignment testing. Dr. Prabha shows you a target and checks for residual deviation or diplopia. Adjustments are made by advancing or recessing the muscle in small increments until alignment is satisfactory. The suture is then permanently tied and the patient is sedated again or the procedure concludes.
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Recovery and Post-operative Care
After surgery, the eye is not routinely patched — you will be able to see through the operated eye, though vision may be blurry from the ointments. Mild pain, grittiness, and redness are expected and managed with oral analgesics. Antibiotic-steroid eye drops are prescribed for 4–6 weeks. The eye will be red for 1–2 weeks and may have some swelling. Most children return to school within a week; adults return to work within 3–7 days. Adjustable sutures, if used, are finalized on post-operative day 1. Follow-up visits are at day 1, week 1, month 1, and month 3.
How to Prepare
- •Complete a full orthoptic evaluation including cycloplegic refraction (especially for children), prism cover test measurements, ocular motility assessment, and stereopsis testing — bring old photographs if the squint onset date is unclear, as they help determine duration
- •Follow fasting guidelines strictly for general anaesthesia — typically 6 hours for solid food and 2 hours for clear liquids (infants: 4 hours for breast milk)
- •Bring all previous glasses prescriptions and patching records — Dr. Prabha needs to know what non-surgical treatments have been attempted and for how long
- •Discuss realistic expectations — squint surgery improves eye alignment significantly but perfect alignment may require more than one surgery in complex cases; glasses may still be needed after surgery; patching for amblyopia may need to continue even after surgical alignment
- •For adults: arrange 5–7 days off work and for driving (do not drive for at least 48 hours post-anaesthesia, and until diplopia — if any — has resolved or adapted)
- •For parents of children: prepare the child age-appropriately, bring a comfort item, and arrange for a parent to be available full-time for the first 2–3 post-operative days
Related Conditions
Squint Surgery (Strabismus Surgery) helps diagnose and monitor these conditions. Explore our condition pages for more detailed information about each.
Frequently Asked Questions
At what age should squint surgery be done?
The timing of squint surgery depends on the type and severity. Infantile esotropia (constant inward deviation present by 6 months of age) is ideally operated on between 6–12 months to maximize the chance of developing binocular vision. Intermittent exotropia may be observed and operated on in the preschool or school-age years if the deviation is increasing in frequency and magnitude. Accommodative esotropia is usually managed with glasses first — surgery is reserved for the non-accommodative component. There is no upper age limit — adults with long-standing or acquired squint benefit from surgery for diplopia relief and cosmetic restoration. Dr. Dibya Prabha evaluates each patient at Palamu Neuro & Eye Care, Palamu and recommends the optimal surgical timing.
Is squint surgery painful?
During surgery, anaesthesia ensures you or your child feel no pain. After surgery, most patients experience mild to moderate discomfort described as a gritty, scratchy, or sore sensation rather than sharp pain. This is well-managed with oral paracetamol or ibuprofen. The eye will be red and may water more than usual for 1–2 weeks. Severe pain is uncommon and should be reported to Dr. Prabha promptly. Children typically recover with remarkable ease and are back to playing within 2–3 days, though water and contact sports should be avoided for 2–4 weeks.
Will I need more than one squint surgery?
The goal of the first surgery is to achieve the best possible alignment with one procedure. Approximately 70–80% of patients achieve satisfactory alignment with a single surgery. However, strabismus surgery is not like cataract surgery where you replace a lens once — eye alignment is a dynamic system, and some patients (about 20%) may need a second procedure, especially in cases of large-angle deviations, paralytic squint, reoperation after prior surgery elsewhere, or when fusion is poor and the eyes have no binocular incentive to stay aligned. Dr. Dibya Prabha discusses the likelihood of reoperation for your specific case during the pre-operative consultation.
How much does squint surgery cost in Palamu?
The cost of squint surgery at Palamu Neuro & Eye Care, Palamu depends on whether one eye or both eyes are operated on, the number of muscles adjusted, the technique used (standard vs adjustable suture), and the type of anaesthesia required. Dr. Dibya Prabha provides a detailed, personalized cost estimate during your consultation. The clinic is committed to affordable, transparent pricing for patients from Palamu, all districts of Jharkhand, and neighboring states including Bihar, Odisha, and West Bengal.