Eye Muscle Surgery

The purpose of eye muscle surgery is surgery to weaken, strengthen, or reposition any of the muscles that move the extraocular muscles that control the eye. Eye muscle surgery can be performed on patients at various age groups to help improve their vision.

The extraocular muscles attach via tendons to the sclera (the white outer protective covering of the eyeball) at different places just behind the eye. The other end of each of these muscles attaches to a part of the orbit (the eye socket in the skull). These muscles enable the eyes to move up, down, to one side or the other, or any angle in between.

Typically both eyes move together, receive the same image on corresponding locations on both retinas, and the brain fuses these images into one three-dimensional image. The exception is in strabismus, which is a disorder where one or both eyes deviate out of alignment, most often outwardly (exotropia) or toward the nose (esotropia). The brain now receives two different images, and either suppress one, or the person sees double (diplopia). This deviation can be adjusted by weakening or strengthening the appropriate muscles to move the eyes toward the center. For example, if an eye turns upward, the muscle at the bottom of the eye could be strengthened.

There are two methods to alter extraocular muscles. Traditional surgery can be used to strengthen, weaken, or reposition an extraocular muscle. The surgeon first makes an incision in the conjunctiva (the clear membrane covering the sclera), then puts a suture into the muscle to prevent it from getting lost and loosens the muscle from the eyeball with a surgical hook. During a resection, the muscle is detached from the sclera, a piece of muscle is removed, so the muscle is now shorter, and the muscle is reattached to the same place. This strengthens the muscle. In a recession, the muscle is made weaker by repositioning it. More than one extraocular eye muscle might be operated on at the same time.


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