Staring surgery in the eye: Consenting to squint correction surgery in our six year old

Back in 2015, one of the earliest things I wrote about was our journey after discovering our one year old daughter needed glasses. As she grew and grasped self perception, around age three we went through a phase of finding her specs down the back of the sofa, as she started to realise her own image and would clearly have preferred to gone without them. 

Tigs is now six and a half, and wearing glasses is a norm for all her as it is for us seeing her with them. Part of her everyday life and as she has learnt to read and write, despite seeming to cope okay without them, she can now vocalise how she can in fact see clearly with the glasses and prefers to wear them to aid her day to day tasks. Just like a lot of people wear no glare glasses when they’re working at the computer only, but then they don’t for the rest of the day.

Her squint, which was the first sign of any visual impairment, remains severe when she removes her glasses, however she hasn’t particularly noticed it herself. Of course now she is a keen swimmer and gymnast, for us, we have always hoped that something could be done to improve her squint and straighten her eyeline when the glasses are off, however have accepted that this may not be possible.

Over the years we have continued to regularly review, monitor and adjust her glasses prescription, we have patched on and off, and the message has always been clear – she is severely long sighted and as such will always need glasses. As the glasses straighten her squint, she was not applicable for surgery to correct the squint with the glasses off.

In the more recent reviews, we were told that her squint with the glasses on, whilst not obvious to us, is now in fact deteriorated to the point it qualifies for surgery, thus opening up an opportunity to discuss with an eye surgeon. At the first consultation appointment, we were offered squint correction surgery which her consultant believed would align her eyes with the glasses on, and vastly improve her binocular vision and squint also with the glasses off.

He explained that her eyes are struggling to work together, has no 3D vision, and as she is young, her eyes are still developing and therefore able to cope, over work and adjust, up until the age of seven or eight when the eyes development period is complete.

Therefore, now is the time that we may be able to make improvements to her binocular vision – the way her eyes work together – and improve both her eye appearance and function, before that window of opportunity closes for good.

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Signing a surgical consent form as a parent is not easy. We realise in the grand scheme of things that this is a minor operation, and many parents before us will have had to signed on the line for far scarier procedures with more major consequences. That said, when a member of the medical profession has just read the long list of risks and possible side effects of an impending surgery under general anaesthetic, it takes a steady hand to put your scribble on that paperwork.

We’ve been here before – when the Mouse had a lump removed from her tiny earlobe under a general anaesthetic at age one. Again, a simple procedure, but one that undoubtedly put everyone through a great amount of distress. he of course bounced back almost immediately, and on getting the all clear that the lump was benign, we were incredibly relieved and glad we had eliminated any questions of the nature of the mass by surgery.

For this particular procedure, to tighten or shorten Tig’s eye muscles, there are many worries and concerns for us as her parents. Could her vision be permanently damaged? Double vision is a realistic side effect but in children, they can usually correct this in a short time by adjusting their focus. Could her squint worsen – with or without glasses, perhaps making the squint worse – turning her eyes out or in more? Will there be very little benefit at all, therefore putting her through a painful and stressful experience for little gain? The eyes are a very delicate and complex organ which like many of us, I cringe at the thought of being touched, and the very thought of them being damaged is just beyond imaginable.

Closeup Photo of Human Eye

Aside from the squint, Tig’s glasses prescription and vision need to be also weighed into the equation. Her glasses currently straighten her eyes and so post surgery, will need to be adjusted. The immediate result will not be the long term result and we will need to wait and see how her eyes heal and the muscle reattaches. The prescription will then be adjusted to straighten the eyes from their new baseline, and hopefully, reducing the weight of her heavy and strong lens prescription from its current state.

Nonetheless, the consultant has been reassuring that whilst this surgery is optional, it is in his experienced opinion, strongly reccommended. It is also, in his field, a routine procedure that will be over very quickly. Sometimes, all we can do as a parent, is trust in those who know more than us, and when it comes to Opthalmology, that’s basically anyone who has any knowledge in this incredibly technical and confusing field.

Close-up Portrait of Human Eye

There are no doubts that as we set off this week to take Tigs into the unknown, our hearts will all be in our mouths. We are showing a positive and brave face for her, as we realise that she isn’t always the bravest patient herself! Toys and treats at the ready, we’ve sold it to her based on the time off school and being made a fuss over. But ultimately, as her mother, I’m thinking ahead to Tig’s of the future, and believing that this is the decision she would want me to make for her on her behalf.


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