Strabismus Service, Adult

Patient's fears are put at ease after successful strabismus surgery

Jill Braverman was born with strabismus and underwent eye muscle surgery as a baby to correct the problem. Luckily, the operation was successful and her vision developed normally in both eyes. She lived most of her life without any problems. But at age 28, she began to develop double vision. She also began to notice that at times her eye appeared to be slightly misaligned.

Double vision takes a toll

"I noticed that if I stared at the computer too long I would see double," she said. "In pictures, my eye looked slightly turned. The double vision got progressively worse until it began to affect everything I did: my dance teaching, swimming, exercising, driving and my social life."

Her problem, Jill said, wasn't that her eye was noticeable, because most of the time her eye did not appear to be out of line. It was more that she had to constantly adjust her head position so that she could see straight. For instance, when teaching dance, she would have to tuck her chin down very low into her chest so that she could see her own feet.

"When you have double vision it becomes very difficult to concentrate," she said. "It's very distracting to the point where you almost feel disconnected from everything around you."

Hesitant to have surgery

When Jill's symptoms began, she was living in New York City. She saw a few ophthalmologists but felt uncomfortable having surgery.

"I saw several ophthalmologists but I didn't take any action because, quite frankly, I didn't like their personalities and I didn't feel I could trust them," said Jill.

Feeling comfortable at Children's

Dr David Hunter It wasn't until a couple of years later, after moving to the Boston area, that Jill was referred to David G. Hunter, MD, PhD, Ophthalmologist-in-Chief at Boston Children's Hospital. Dr. Hunter sees many adults with strabismus who come to the hospital's Eye Center.

"When I met Dr. Hunter, I immediately felt comfortable," she said. "He has an amazing bedside manner and you can tell that he really cares about his patients. He was very clear with me about the operation itself, the success rates and what they mean. I felt like he understood my concerns and listened to me."

In fact, Jill said, Dr. Hunter explained that her childhood eye surgery was not a failure.

"He explained that since I had my first operation as a baby, I was actually lucky that my eyes stayed perfectly straight as long as they did and that it was fairly common for the eye to eventually wander again," said Jill. "Prior to that, I had the feeling that my first operation failed and that perhaps some other bigger health problem caused it to fail. No one else bothered to explain that what happened was perfectly normal."

Operation fears

Before deciding on surgery, Dr. Hunter prescribed prism lenses for Jill's glasses to see if that would help her double vision. Although it did help, Jill decided she didn't want to be dependent on the glasses and opted for eye muscle surgery.

Her biggest fear, she said, was a potential bad reaction to general anesthesia because in a previous operation for an unrelated problem she became very nauseous.

"The anesthesiologist was absolutely wonderful," said Jill. "She listened to what I had to say. I told her about the medications that were used previously and she explained to me what she was going to do differently and I felt completely fine after the surgery."

Above and beyond

The day after her follow-up appointment a few weeks after the surgery, Jill suddenly saw halos around lights.

"So at 7 o'clock at night on a Friday, I called Dr. Hunter because I was seeing a halo around the light," she said. "I told him that I didn't think it was a big deal and he said, 'No, you have to come back in now.' So he wound up staying late to help me with this."

These "halos" can be a sign of glaucoma in some cases. It turned out that Jill had gotten a piece of sawdust in her eye, which was easily removed, and the halo went away.

Successful results

Jill said she is happy with the outcome of her surgery and the overall experience she had with Dr. Hunter and the Children's team.

"From beginning to end, I couldn't believe how easy the whole thing was," she said. "I was there for a total of around three hours. When I woke up, the problem was just gone and I immediately had a good result. I'm driving fine and doing all the things I want to do without having to worry about double vision. I would definitely recommend that anyone with strabismus go to Children's."