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Does my son need to undergo muscle surgery for lazy eye?

Q: My five years old son underwent an eye check up last year. His power for the left eye is -4.0 cylindrical and for the right one is -3.75 cylindrical. I also noticed lazy eye in his right eye. After check up, he started wearing glasses. The doctor has advised patching the good eye for an hour but it wasn’t consistent. After three months, his lazy eye / squint has not improved. Now, the doctor has recommended a muscle surgery for both his eyes (Bi-lateral squint operation). Does my son need to undergo a muscle surgery for lazy eye? Will patching help improve the lazy eye? How can I prepare my son for the surgery?

A:Muscle Surgery (i.e. Squint Surgery) can not correct a lazy eye. It will correct the squint (crossed eyes).

Patching helps to improve a lazy eye as it forces the lazy eye to be used. Generally speaking, patching is done for 4-5 hrs daily in a 5 year old. His mother should reconfirm this with her strabismologist / Paediatric Ophthalmologist.

Some of the queries raised by her are best discussed face to face with her son’s eye doctor (viz. preparing the child for surgery, what to expect after the operation, pros and cons of the surgery). Generally, surgery is performed once the vision in both eyes is equal (i.e. after correction / improvement of lazy eye). Surgery is done to re-align the eyes so that some binocular vision/ stereopsis etc. develop. It is always advisable to explain to your child what to expect at the hospital or at least reassure him in some way so that he will not over-react at the time of surgery.

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