inferior oblique ectomy results

Hello whoever's reading this.
Exactly 9 days ago I had an Inferior Oblique Ectomy surgery in my right eye, which went without problems apparently, and the eye is almost back to it's normal white colour after some redness and i'm virtually in no pain or discomfort now (unless i look in certain extreme angles).
After some googling I've discovered what my problem probably is is Fourth Nerve Palsy, as I had all the symptoms: double vision, head tilting and turned slightly to the opposite side, and slightly droopy bad eye, the good eye definitely being the dominant one, as well as a little facial asymmetry.
My surgeon did not tell me the name of what my problem might be, I didn't ask, and i guess inevitably you don't know what you should ask until after the fact somewhat.

Anyway, so previously I was getting single vision by turning and tilting my head slightly as described above, so I was effectively looking slightly to my right to look straight ahead, and looking towards my left would produce double vision (my right side was my good side)... now it is quite the opposite... i get quite good single vision when i look to the left, almost to the most extreme left (when my right eye is looking at my nose) - I remember this vision to the right was quite nauseating up until a few days ago (post op), but now my brain has adjusted to the change in expected vision (i don't suffer nausea now) I'm quite happy with this!
However when i look to the right, maybe just 10 degrees from centre, i get double vision, and i'm finding it quite hard to correct this when i try to really concentrate, I'm not happy at all with this. Will this get better? My surgeon said I won't really know what it'll be like in the end until after 3 months (forgot to mention I needed 4-degree prism glasses to fix it when she tested me originally).
In terms of left and right vision, it seems that this has happened:
Looking left:
PreOp: Double vision at about 25 degrees from centre
PostOp: Double vision at about 45 degrees from centre - happy with this!
Looking right:
PreOp: Double vision at about 35 degrees from centre
PostOp: Double vision at about 10 degrees from centre - NOT happy with this!

The worst part though is that it seems I have very little vertical control over my operated (right) eye now. I have to keep my head level as I cannot look up or down very far at all before it goes double. I don't have any memory of this previously being a problem (although it may have been and I just was so used to it). It is definitely far worse though. Especially when i look up - When i look up my right eye's vision now rotates to the right about 15 degrees i'd say, and this throws my balance.
I performed a test on myself, walking or driving along in a straight line when i close my good (left) eye and when i tilt my head down, so i'm looking up to look straight ahead, it's like the world rotates 15 degrees and i feel like i'm falling over to my right and i either steer right or start walking to the right to correct this. I feel quite uncoordinated, and am not happy with this!
However, in the past day or two only, I THINK I MAY have noticed that my brain is getting used to this and I don't feel as compelled to 'correct' this feeling like I am falling over.
Also, probably related, when I just close my left eye and tilt my head left and right, left and right, etc, it's like the world is spinning as I do it. However when i close my right eye (just using my good left eye), it just feels as if the world is stationary and i'm just rocking my head left and right. That is how I would describe it.
Is this going to change, as it is very difficult to do anything which requires coordination as I'm moving about quickly, like sport?

I've watched some videos of my operation on YouTube and it seems what is done is literally - and almost crudely - cut the muscle in half. Is this so? Or is it just a portion of the muscle that is cut in half, and there are still two ends of it somewhere still connected? Is this muscle entirely disabled?
If it is entirely disabled, then how am I meant to hope that I will get much improvement in the current areas where my double vision is now newly quite bad?
Is it that the other eye muscles will take over and start doing the old muscle's job over time?
Are there any eye-exercises I should be doing to maximize my single vision for the future? I've been trying to concentrate and push the limits of what i can achieve singularly when I get the chance during the day.

If 50/50 means that my vision has gotten no better and no worse, 9 days hence, I would say it's probably gotten 60% better, 40% worse (meaning that mostly what was originally double is now single, and some of what was single is now double - but the difference is only slight!), which is not good enough if you ask me, as I was told that 'It should solve the problem for me, and that I would notice some immediate considerable improvement', which I can't really say I have, and I'm a bit angry and frustrated about it.

I have an appointment with my specialist/surgeon at the end of this month to follow up my progress I suppose. I don't want to ring her up prematurely and express my anger. I don't want to jump the gun as it may get better.
Any advice or my questions answered would be fantastic.

[John C Hagan III, MD, FACS, FAAO]

1. Ask the surgeon the exact diagnosis your were treated for; the exact surgical procedure; ask for a layman description of what was done.
2. You have been told it will be several months before the results of the surgery will be stable and your success evaluated.
3. You can make a list of your quetions and call the staff if you don't want to wait till your next visit.

JCH MD

[papalaza]

Thanks John for your input.
1. I know that what I said above was the exact surgical procedure I had.
2. I know this, but that doesn't answer the questions I had about what I can expect or what might possibly happen/how the recovery of the muscles/brain work.
3. I had made the list of questions here, hoping my descriptions might describe something typical for somebody who had had this operation 9 days ago.

[John C Hagan III, MD, FACS, FAAO]

Last comments:
1. You did not have an "ectomy" that's not a procedure. Likely you had an inferior oblique myectomy.


JCH MD

[papalaza]

Sorry John, that is correct. It was a myectomy - missed a syllable.
Could you perhaps put my fears to rest a little?
I'm wondering especially if any exercises might help.
Also if my descriptions above sound typical and to be expected but not permanent hopefully!

[John C Hagan III, MD, FACS, FAAO]

Sorry: these cases are not "routine" and defy generalization. You might use the search feature and archives to see if you can find any previous discussions.

JCH MD

[papalaza]

Does this operation mean that the muscle is entirely disabled/put out of use?
If so, does that mean that the other muscles have to start to try to do the old muscle's job?