Has forth nerve palsy surgery ruined my eyes?

[MissSarahJ]

I had surgery two weeks ago for forth nerve palsy in my left eye that I’ve had from birth causing double vision when tired and when looking in certain directions. My eyes were straight otherwise and my left eye seemed to drift upwards and very slightly to the left on occasion. Now my operated eye isn’t quite straight and seems to be constantly slightly to the left as apposd to central! It’s only slight but I’m so stressed about it! I wanted to be better not worse! The surgeon said he only operated to stop my eye from drifting upwards! Will this correct itself? I also had another issue after the op which makes me question the skills and genuinity of my surgeon! Feeling stressed!

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

There are 6 external eye muscles on each eye for a total of 12 muscles. Each has to be perfectly aligned and work in perfect balance in all directions for the eyes to be straight all the time. Given this complexity its amazing so many people have normal eye muscles.  Many eye muscles including the 4th move the eyes both up/down and to a certain extent in/out so doing surgery any of them can affect not only vertical but also horizontal positions.  Virtually everyone feels eye strain at your stage.

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

It will be several months before you know the final position of your eye and whether you deem it 'successful' or not. Under correction/ Over correction  are extremely common with eye muscle (strabismus) surgery.   Roughly 10% of cases require additional surgery.

[MissSarahJ]

I understand that but I don’t understand why my operated eye would now be slightly outwards when it was straight before and the surgery was only to stop my eye drifting upwards!? Has something gone wrong? My eyes feel strained most of the time.