Ok, so I will try to make this simple. There are 6 muscles (each muscle has a nerve) that controls the movements of each eye. One on each side and two on the top and two on the bottom. In embryonic development the area that the nerves are in for each muscle is extremely sensitive to any swelling - they believe that somewhere between 5 and 8 weeks gestation this area can become damaged quite easily resulting in strabismus (misalignment of the eyes). Avery was born with this issue and it has not changed at all over the past almost year. They believe she has whats called Duanes syndrome - which is basically a stabismus disorder that you are born with. Her's affects her left eye (which is the most common, also more common in females) Her left eye is sorta "stuck" if you will in a crossed position, in toward her nose. She can move the left eye out toward her ear when she looks down, but not like you and I do. In this disorder the nerve that controlls the lateral rectus muscle (muscle located on the outside of the left eye that moves the eye outward toward the ear) is either missing or became damaged during that sensitive portion of embryonic development.
So, her first surgery will take place next friday in which they will release a few millimeters of the medial rectus muscle in her left eye. (This is the muscle on the inside of the left eye - near the nose) Hopefully this will result in a more "midline" eye position for the left eye. It may take more than one surgery, and tweaking more than one muscle eventually - but this is our starting position. Also, we may not have an idea if the surgery is successful until about 4-6 weeks post-op. These conditions often require a few surgeries to achieve the most optimal outcome - which is maintaining bi ocular vision (using both eyes together) Kids have the unique ability to use just one eye , if they see crappy from the other. If this continues, the vision will permanently be damaged in the one eye that they sorta "turn off" - so this is what we are trying to avoid. We have been patching her eyes since about 3 months old - and tests show she is using both eyes so far :)
the surgery is outpatient and relatively short. She will have antibiotic drops or ointment for 7 days and may have some bleeding in the sclera (white part of the eye) for a few weeks. Actually it will bleed initially, but take a couple weeks to reabsorb, it wont be continually bleeding (we hope) It is all done through the eye socket - no visible incision or sutures and is a VERY common procedure for opthomologists.
It's still slightly more complicated that what I have explained here - but this is the general idea.
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