Strabismus Service, Adult

Patient hopes to dispel myth that strabismus in adults is incurable

For nearly two years after taking a terrible fall that left her with strabismus (misaligned eyes), Janet Gurski, 72, searched for treatment that would restore her depth perception and alleviate the double vision that became unbearable. Yet, she was repeatedly told that there was no cure and that she would have to live with it.

Seeing double

When the accident occurred, Janet fell face first into a plant stand after rushing up the stairs to answer the phone. Initially, she had no eye symptoms and was relieved to learn that X-rays showed no damage to her prosthetic hips and knees. It wasn't until several months later that symptoms of strabismus slowly emerged and progressed.

First, she began seeing two of everything. Then, when she drove, it became difficult to judge the distance between her car and cars around her. It became impossible to follow print across the page of a newspaper, read a book and watch television.

"I would see the TV image and the same image above it," she said in an interview. "Those news headlines that run along the bottom of the screen on some shows became particularly annoying when you have to see two of them."

Losing independence

But the worst part, Janet said, was her increasing dependence on other people, particularly when she had to go somewhere.

"I didn't want to take any chances driving and my family was afraid for my safety and the safety of others," she said. "So I only drove very short distances and had to be sure I was home before dark. Basically, if I needed to go anywhere, I had to have my family or a friend drive me."

A disheartening diagnosis

Initially, Janet saw an optometrist and two different ophthalmologists. Ophthalmologists diagnosed her with strabismus caused by trauma to an eye nerve that controlled muscles that move the eye. The first ophthalmologist she saw said she'd have to play the waiting game.

"He said (the condition) would either stay the same, get worse or get better," she said. "To me, that wasn't much help."

Janet was told that her only hope was to find a lens prescription to lessen the symptoms. When she tried using a prism in one lens of her glasses, the symptoms remained the same. Using prisms in both of her lenses decreased the double vision but did nothing to restore her peripheral vision.

A third ophthalmologist at the Lahey Clinic Medical Center prescribed stronger lenses which seemed to help more. Because Janet had to switch to bifocal lenses, however, she was told the stronger lenses wouldn't work with bifocals. It was this ophthalmologist who told her that pediatric ophthalmologists at Boston Children's Hospital specialize in eye muscle surgery to correct strabismus and may be able to help her. He referred her to Linda R. Dagi, MD, who routinely performs eye muscle surgery on adults.

Hope at Children's

"Dr. Dagi is a wonderful doctor and I want other people who have similar problems to know that she exists," Janet said. "She explained that the nerve was causing problems in two eye muscles. During the surgery, they would adjust the muscles so that they could make the weaker muscle a little stronger and the stronger muscle a little weaker. This was the first time I was given hope that my problem could be fixed and I was elated."

Janet underwent surgery at the Beth Israel Deaconess Medical Center, which is adjacent to Children's Hospital and is one of several off-site locations where adult patients are treated by Children's physicians.

She said her biggest concern going into surgery was anesthesia and the terrible nausea she experienced in past operations. She explained her fears to the anesthesiologist in a preoperative meeting and she was given special medication to prevent the vomiting.

A successful cure

"Before I knew it, the surgery was over and I was in recovery and had no problems with the anesthesia," Janet said. "And now, I'm really okay. I don't have double vision and I can drive long distances without any problems."

Still, she said, she is frustrated when she thinks of all the time wasted before she had the corrective surgery.

"I just wish I knew about Dr. Dagi sooner. It would have helped save a lot of people a lot of worry and heartache and it would have saved me from a lot of sitting at home," she said. "I want to be able to share my story so that people know that yes, something can be done and it's my hope that they don't have to wait as long as I did to find the right doctor."