Strabismus Service, Adult
Life changes dramatically for patient after overcoming strabismus
Steven McCarthy never imagined he would someday drive without heavy glasses, participate in sports or be able to sit through a movie or play without developing headaches.
Painful prism glasses
During the years after he developed strabismus (misaligned eyes), Steven's condition became so bad that he saw double of everything beyond eight feet in front of him. The strength of his prism glasses, which helped him see normally, was increased in increments until he reached the highest strength available.
"The glasses were so heavy, and after wearing them a short time, they gave me a headache," Steven said. "Plus, you can't use them too much or, I was told, your eyes have the ability to adjust to them and could become dependent on them to see. My condition could worsen if I wasn't careful."
Onset of strabismus
Steven, now 45, developed strabismus during adolescence, which is atypical. Most people are either born with the condition or it can result from disease or injury. At the time, his ophthalmologist suspected a brain tumor and performed tests to rule out cancer.
"It was assumed that it was either a brain tumor or I hit my head in some way, but I have no recollection of hitting my head," he said.
After ruling out disease or injury, it was determined that the condition probably had been there all his life but worsened at puberty.
Steven was told by several physicians that nothing could be done to correct the problem. One ophthalmologist, who did say surgery might be an option, outlined a plan for three or four operations. But the doctor wasn't optimistic about the outcome.
"He did not seem very hopeful," Steven said. "I probably would have gone through with it if he seemed more confident that it might actually work. So, because of his lack of confidence, I did nothing."
Instead, Steven spent years struggling with his condition. He recalls that in college he always had to sit in the very front of the class so that he could see the blackboard or even the instructor. He couldn't play sports because his vision affected his ability to see the ball.
He couldn't swim from one end of the pool to the other and he continually struggled with day-to-day tasks. For instance, finding his car after leaving the supermarket or shopping mall was always an annoying problem. At work, he always looked down to avoid double vision and headaches. His inability to make eye contact was often misconstrued by coworkers.
"The condition played havoc with my self image," he said. "Its effect on my physical appearance seemed to me like a fatal flaw. In my mind, it was the first thing that anybody saw."
Children's offers promise
Dr David Hunter It wasn't until 2004 that Steven was given any hope. "My headaches were getting worse and my glasses were getting thicker," he said. "And I saw an ophthalmologist in Boston who said, and I remember her exact words, 'There 's a new doctor in town and he specializes in your condition.'"
Immediately, Steven said, he booked an appointment at Boston Children's Hospital with David G. Hunter, MD, PhD.
"When I met Dr. Hunter, I felt like I met a savior," he said. "He was confident, capable, secure and comforting. He had a plethora of knowledge about the condition and he seemed to understand how I was looking at the world. He made me feel comfortable about the diagnosis and comfortable with the treatment."
In June of 2004, Steven had eye muscle surgery as an outpatient at the hospital's Lexington location. During the procedure, which is performed under general anesthesia, the eye muscle or muscles causing the misalignment are separated from the eye and reattached to a new position. In most adults, adjustable sutures are used that allow surgeons to make further adjustments to the eye if needed after the patient wakes up.
The procedure itself, Steven said, lasted around 40 minutes. He adds that he doesn't recall feeling any pain when adjustments were made to the sutures after waking.
A new life
"For me, this was a miraculous, life changing event," Steven said. "I have no double vision whatsoever. I can look at things at a great distance. I'm a better driver and I don't need to wear glasses."
"When I meet people I have more confidence now and I can look them straight in the eye," he said. "But perhaps one of the biggest benefits is that I can play ball with my 13-year-old son."