AJ’s story
6-year-old AJ developed pronounced squints – where both eyes looked in different directions – three years ago.
Despite different treatments, his condition continued to deteriorate and the only option to correct them is surgery.
AJ arrives at the ophthalmology department at the Royal Victoria Infirmary with his parents Anna and Michael – for surgery to correct his squints.
Before his operation he see Advanced Orthoptist Jenny Earl who needs to assess AJ’s eyesight and collect vital information the surgeon needs to correct his squints.
Jenny checks the vision is good an equal and does some measurements explaining why these checks are so important “Information we collect during the assessment lets the doctor know there is equal vision – there’s usually a better outcome of surgery if they can see the same in both eyes.
“The measurements we do with the prisms allows the consultant to know how much he needs to tighten or weaken the muscles.”
With the assessment complete it’s time for Jenny to take AJ to ward 8 at the Great North Children’s Hospital to hand over to the surgical team.
AJ’s dad Michael says: “I wasn’t sure what a squint was – I almost thought it was something you did in the sun – but then we found out it is a bit of muscle deficiency.
“We’ve tried the glasses and we’ve tried the patches to try to see if we can correct it itself and it never has. I think it’s a route we’ve probably always had to go down anyway.”
Making the decision to go ahead with squint surgery can be difficult for parents explains Jenny: “For the parents making a decision to have the squint corrected can be a big decision because obviously it is a cosmetic thing it’s not something that they medically need treating but it can affect the way their child might be treated at school or their confidence.”
It’s time for AJ to go to theatre for a little sleep….what is he going to dream about? Pizza of course!!!
“When they said surgery would be the route we’d be going down we had a big long discussion about it. Should we be going down this route? Could we leave it? Could we do other things? But we had tried everything else.” Explains Michael.
“We’re not doing this for cosmetic reasons, we’re doing this for the long term benefit for him, for confidence – it’s going to hopefully prevent him from getting picked on for it.” Adds Anna.
“For me one of the big things is coordination – for sports and things which is something I’d really like to get him involved in – the benefits are going to outweigh the worrying.” Continues Michael.
Performing AJ’s surgery is paediatric ophthalmologist Mahmood Nassar who explains what the procedure entails: “The surgery includes weakening or tightening of muscles to realign them again. In this young man’s case the aim would be to weaken the two muscles that are overturning the two eyes in and tightening the one muscle that is not puling the eye out as it should to make the eyes straighter.
“People tend to be very very anxious around their eyes which is understandable. The first thing asked usually is – do you get my eye out or not? and the answer is no – we don’t take it out then fiddle with it and put it back in again. This procedure is done around the eye, so we go around the eye and find the muscles that we weaken or tighten.”
AJ has been in theatre for half an hour and his parents are waiting anxiously for him to get back to the ward. “It’s really strange – the waiting is like a killer.” Says Anna “I just want to see him and give him a hug and a kiss hopefully not too much longer to wait.”
Michael adds: “I’m feeling anxious now – just want to see him – it feels like an eternity. He’s been away quite a while so I’m anxious now to see him and see how he is – make sure he’s alright.”
This procedure could transform AJ’s life but its intricate surgery – “From a surgical point of view the main risk of having squint surgery is related to over correction. Other risks are very rare, so risks of infection bleed or loss of sight are extremely rare.” Explains Mahmood.
AJ’s right eve is now done, and Mahmood now moves on to his left eye which only needs one muscle adjusting. Mahmood continues: “At his age there are lots of social issues around a squint. Friends and community can be really cruel and tough on a young kid and that’s really something that he can take out of the procedure. Once this is aligned this puts things back to how they should be and then it removes that bit of social stress.”
With the surgery complete it’s time for AJ to go back to the ward and back to his mum and dad.
A visit from Mahmood confirms everything went to plan “So that was straight forward from a surgical point of view so as planned we weakened two muscles ad strengthened one muscle. Give him a bit of time to settle and we’ll see him again for a measurement and take it from there but from a surgical point of view that was straight forward.” He says.
A relief for his parents – Michael says: “It’s good to hear the surgeon say it went well so that’s a positive. It’ll just be nice to see him when he wakes up and a little more himself.”
Following a successful operation both AJ’s squints are gone and he’s starting to play sport!
