Currently recovering from eye surgery; a bit concerned and have a few questions

[fourthnervepalsy]

Yesterday I had an inferior oblique myectomy surgery to treat my fourth nerve palsy and the double vision I get when I read things up close (requiring me to shut one eye) as well as the strabismus it causes. A little more information about the condition can be read in a previous thread of mine, here: http://tinyurl.com/oldereyethread

My doctor told me the surgery went fine. I had an eye patch on throughout all of yesterday and have been experiencing a pretty intense discomfort/irritation in the eye, sort of like the feeling when you have an eyelash stuck in your eye except this is a big eyelash that bothers you every time you blink and can cause sudden stabs of pain if you blink the wrong way. I believe these are from the stitches in my eye. This morning my doctor took off the patch; when looking through both eyes for the first time post-surgery I thought I was going to throw up. I felt extremely nauseas and my vision of everything in the room was slanted at about a 45 degree angle in one eye and was straight in the other, causing severe double vision and dizziness. I've never had double vision before unless I'm looking at something up close, but now I have it whenever I look at anything with both eyes no matter what distance. I have kept my eyes mostly closed since then and am currently typing this with just my one good eye squinted open. So here are my questions:

1. How normal is the crazy double vision/seeing everything at two totally different angles after a surgery like this? Is it bad or does it mean the surgery went wrong? If not, why am I experiencing it and how long will it take to go away and get back to normal?

2. The stitches in my eye are still irritating me a great deal. They are dissolvable and will supposedly dissolve completely in 2 to 4 weeks. Will they be bothering me this much that entire time? Will the feeling noticeably improve at any point or will I still feel like there's an eyelash or a piece of dirt in my eye until they've completely dissolved several weeks from now?

3. Right now I don't want to open my eyes at all. Like I said, the slantedness and opposing angles I get when looking out both eyes is incredibly offputting and nauseating. I can open my good eye only (like I'm doing now) but my other eye is still very tender and light-sensitive and I want to keep it closed. How important is it that I either do or don't open my eyes over the next few days? What will make them heal/go back to normal the fastest?

Thank you in advance for any and all help, it is MUCH appreciated.

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

You need individualized information from your surgeon. Get on the phone and speak with him/her. That's the only way to get the reassurance and info you need.

JCH MD

[fourthnervepalsy]

An update...I have been keeping my bad eye mostly covered, occasionally testing it out on its own or opening them both at the same time.  Opening both at the same time is very unpleasant still, but there is not such a drastic difference in angles between the two eyes.  If I tilt my head to the left it gets better, if I tilt it to the right it gets worse.  It gets worse when I move my head up or down.

What bothers me most now though is this...I finally got brave enough to open both eyes and look in the mirror.  My eyes are pointing two entirely different directions.  Even if I can sort of focus them so that the double vision mostly stops, the pupils are pointed in opposite directions.  Before, this would only happen when I looked at something up close...my left eye would drift up while the other eye remained in place, and that was embarassing enough as it was and that was also a big factor in why I got this surgery.  To have my eyes pointing totally different directions ALL the time now is extremely unsettling.  I do not want to be seen in public like this and, again, I'm afraid that permanent damage may have been done.

So...
How likely is it that this will be temporary?  How common is this after a surgery like this?  Why is it happening?  What happens if they stay like this...will I need another surgery?
Again, I'm pretty worried, so any and all help would be very much appreciated.

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

1. It's not uncommon, it usually gets better, it may take several weeks, there is some possibility that it will not get better. This surgery even with a good result rarely eliminates all double vision in all fields of vision.
2. Again could get better or worse. Ask your surgeon to prescribe an ointment that you can use 4 to 6 times day. Also you can often use a viscous artifical tears like cellluvisc.
3. Ask your surgeon this and consider asking the surgeon to look at you daily this week since your recovery is so rocky.

JCH MD