Loyola offers corrective surgeries for adults with strabismus

Loyola University Medical CenterSep 28 2012

Since she was a child, Katie Szymczak has had eyes that wandered. Her right eye, which was the worst, would look up and to the side, rather than straight ahead.

Her husband affectionately called them "googly eyes." But other people could be mean. "They would say to me, 'What's wrong with your eyes, why aren't you looking at me?'" Szymczak said. "It really hurt a lot."

But since Dr. James McDonnell, an ophthalmologist at Loyola University Medical Center, performed surgery to repair the defect, Szymczak's eyes have been in a normal position. "I don't get comments anymore," she said.

But many adults who have this defect, called strabismus, wrongly believe there's no treatment. Many adult patients have had the condition all their lives. Others develop strabismus as a result of such conditions as stroke, tumor or brain injury. Studies show these patients think about their eyes almost every hour of every day.

But Szymczak said that since her surgery, she has been less self-conscious, and more confident doing presentations at work. And she has begun wearing make-up around her eyes. "I feel I can show them off now," she said.

McDonnell has performed thousands of corrective surgeries in children and adults whose eyes are misaligned for various reasons. Patients are given many reasons why they shouldn't get treatment: Nothing could be done after a certain age; they would outgrow the problem; they would need another surgery or if they had undergone a previous surgery nothing further could be done. Some patients are told that insurance won't cover the procedure.

"None of these things are true," McDonnell said. "This type of misinformation can come from friends, family doctors, and even ophthalmologists and optometrists."

McDonnell has performed corrective surgeries on patients ranging in age from infancy to past 90, with excellent outcomes. In addition to restoring normal appearance, the surgery also can improve depth perception and eliminate double vision or eye strain.

About half of the strabismus surgeries McDonnell performs are on adults. To correct the misalignments, he operates on the muscles that control the movement of the eyes. He uses a different technique than those typically used on children. In some patients he uses an adjustable suture technique that allows him to fine-tune the eyes into the exact alignment.

"Our goal is to restore patients' eyes to a normal functional alignment so they can use their eyes together to the best of their ability," McDonnell said. "We want them to be able to look anyone directly in the eye and feel confident that their eyes appear normal. When you can't look someone in the eye, it affects your fundamental ability to communicate. It can be very debilitating."

Risks of the outpatient surgery, which are very rare, include infection and detached retina.

McDonnell said the surgery is very rewarding. "It's wonderful and humbling to see each person after surgery," McDonnell said. "It's a shame when patients wait years to correct something we can address in about one hour."

Some adult patients can be treated with Botox, which temporarily weakens muscles. The drug weakens the pull of a strong muscle, allowing the weaker muscle to gain strength. When the drug wears off in about two months, proper muscle balance and eye alignment often are restored, McDonnell said.