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Minor redness, double vision and under-correction excluded."},"contraindications":["Unfit for general anesthesia due to uncontrolled systemic illness","Active eye infection or inflammation","Unstable or non-stabilized deviation where timing should be deferred (relative)","Active thyroid eye disease; delay until stable (relative)","Recent eye surgery or untreated conjunctival disease (relative)"],"days_in_clinic":{"min":0,"max":0,"unit":"nights","qualifier":"Same-day discharge after uncomplicated primary adult surgery."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":2,"max":4,"unit":"weeks","qualifier":"Light exercise earlier; contact sports and swimming typically delayed until surgeon clearance."},"final_result_months":{"min":1,"max":3,"unit":"months","qualifier":"Alignment typically stabilizes over weeks to a few months; adjustments in alignment can occur early."},"fly_home_after_days":{"min":2,"max":7,"unit":"days","qualifier":"No intraocular gas, so no altitude limit. Fly after a clear first check; many wait about a week."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":1,"max":2,"unit":"days","qualifier":"Often first day after surgery, depending on practice."}},{"purpose":"assessment","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Check of alignment, eye movement and healing."}},{"purpose":"result_review","requirement":"routine","after":{"min":42,"max":90,"unit":"days","qualifier":"Alignment and binocular function review."}}],"indications":["Persistent misalignment of the eyes (esotropia, exotropia, hypertropia) in adults","Double vision from stable ocular misalignment not controlled by prisms","Loss of binocular alignment or abnormal head posture","Visible eye misalignment with functional or psychosocial impact","Paralytic or restrictive strabismus after stabilization"],"main_risks":["Under-correction or over-correction requiring further treatment","New or persistent double vision","Infection or conjunctival inflammation","Bleeding or conjunctival scarring","Slipped or lost muscle","Scleral perforation (rare)","Anesthesia-related risks","Recurrence of misalignment over time","Eyelid position changes","Restricted eye movement or limited ductions from scarring","Need for repeat surgery"],"pain":"Mild to moderate discomfort, scratchiness and redness for several days; usually controlled with simple analgesics.","preparation":["Full orthoptic and ophthalmic assessment with measurement of deviation","Discuss goals, risks, possible adjustable suture or prism trial","Preoperative anesthesia assessment","Fasting before general anesthesia as instructed","Arrange accompaniment and transport home","Review of current medications, including anticoagulants"],"recovery_timeline":[{"phase":"Days 0-3","description":"Eye is red, sore and watery; antibiotic or steroid drops commonly used; double vision may occur.","restrictions":["Avoid rubbing the eye","Avoid swimming","No strenuous activity"]},{"phase":"Weeks 1-2","description":"Redness and discomfort gradually settle; return to light work.","restrictions":["Avoid swimming and eye makeup","Avoid contact activities"]},{"phase":"Weeks 2-6","description":"Residual redness fades; alignment and binocular function stabilize; normal activity resumes with clearance.","restrictions":["Avoid contact sports until cleared"]},{"phase":"Months 1-3","description":"Final alignment assessed; further treatment considered if needed.","restrictions":[]}],"rehabilitation_days":{"min":2,"max":7,"unit":"days","qualifier":"Daily activities resume within days; redness settles in about a week. Heavy exercise and swimming wait longer."},"result_longevity":"Alignment is often long-lasting but can drift over years; some adults need further treatment, and the course varies by type of strabismus.","revision_rate_pct":{"min":5,"max":10,"unit":"percent","qualifier":"One-year reoperation after primary adult surgery; higher with vertical, complex or thyroid-related cases."},"scars":"No visible skin scar; incisions are in the conjunctiva and heal with minimal visible scarring, though temporary redness is common.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One operative session for typical primary adult surgery; reoperation is not routine."},"stages":[{"code":"surgery","label":"Strabismus surgery under general anesthesia","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of the procedure."}}],"qualifier":"Single-stage primary surgery on one or both eyes."},"success":{"metric":"Successful ocular alignment (within 10 prism 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possible temporary double vision."}],"treatment_conditions":["day_case"],"treatment_duration_hours":{"min":0.5,"max":1.5,"unit":"hours","qualifier":"Operating time for typical primary one- or two-muscle surgery in an adult; excludes anesthesia and recovery."},"initial_assessment_documents":["Front photos of eyes in nine gaze positions","Recent eye exam report with refraction","Prior strabismus surgery operative report (if available)","Previous orthoptic or ophthalmology clinic letters","Brain MRI or CT report (if available)","Eye alignment photos from childhood (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery with same-day discharge; stay about 2-7 days to cover first checks before flying home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Talk with the surgeon who will operate about the results you want","scope":"treatment_abroad","source":{"url":"https://www.southside.scot.nhs.uk/surgery-abroad-without-nhs-referral","host":"southside.scot.nhs.uk","quote":"You should always talk to the surgeon who would carry out your operation about the best way to get the results you want.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that you understand the possible complications and side effects of treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check how your aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Check whether follow-up care is at the same facility as the procedure","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Medical tourists should also know whether follow-up care is scheduled to occur at the same facility as the procedure.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C6","text":"Check the facilities and standards at the clinic or hospital","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"A clinic that offers no surgeon consultation until the day of surgery","scope":"treatment_abroad","source":{"url":"https://www.southside.scot.nhs.uk/surgery-abroad-without-nhs-referral","host":"southside.scot.nhs.uk","quote":"Many clinics abroad do not offer a consultation with your surgeon until the day of surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"Advice about treatment given by a sales team member rather than a clinician","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/factsheets/travelling-for-treatment-medical-tourism","host":"travelhealthpro.org.uk","quote":"Medical advice from an administrator, a travel agent, or member of a sales team is not acceptable.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":null,"take_home":{"status":"ok","items":[{"id":"T1","text":"Gives the home doctor your treatment information and future care needs","document":"discharge letter for gp","source":{"url":"https://www.nhs.uk/using-the-nhs/nhs-services/hospitals/being-discharged-from-hospital/","host":"nhs.uk","quote":"You'll also be given a letter for your GP, providing information about your treatment and future care needs.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"T2","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your squint is caused by a problem with your eyesight","name":"Glasses for squint","source":{"url":"https://www.nhs.uk/conditions/squint/","host":"nhs.uk","quote":"Glasses – these can help if a squint is caused by a problem with your child's eyesight, such as long-sightedness.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null},{"id":"A2","text":"You prefer injections over an operation to line up the eyes","name":"Botulinum toxin injections","source":{"url":"https://www.nhs.uk/conditions/squint/","host":"nhs.uk","quote":"Injections into the eye muscles – these weaken the eye muscles, which can help the eyes line up better.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"recession","name":"Recession (muscle weakening)","how_it_works":{"text":"The eye muscle is loosened, which weakens its pull","source":{"url":"https://my.clevelandclinic.org/health/treatments/24488-strabismus-surgery","host":"my.clevelandclinic.org","quote":"A surgeon will tighten or loosen the muscles in your eye.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":1,"max":2,"unit":"weeks","label":"1–2 weeks","source":{"url":"https://www.aao.org:443/eye-health/ask-ophthalmologist-q/can-my-daughter-go-on-amusement-park-rides-after-s","host":"aao.org","quote":"most individuals can resume normal activities around two weeks following surgery","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}},{"id":"resection","name":"Resection (muscle strengthening)","how_it_works":{"text":"The eye muscle is tightened, which strengthens its pull","source":{"url":"https://my.clevelandclinic.org/health/treatments/24488-strabismus-surgery","host":"my.clevelandclinic.org","quote":"A surgeon will tighten or loosen the muscles in your eye.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":1,"max":2,"unit":"weeks","label":"1–2 weeks","source":{"url":"https://www.aao.org:443/eye-health/ask-ophthalmologist-q/can-my-daughter-go-on-amusement-park-rides-after-s","host":"aao.org","quote":"most individuals can resume normal activities around two weeks following surgery","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}},{"id":"adjustable-suture-technique","name":"Adjustable suture technique","how_it_works":{"text":"Stitches are adjusted shortly after surgery while the patient is awake","source":{"url":"https://moorfields.nhs.uk/eye-conditions/strabismus-eye-squint/diagnosis-and-treatment","host":"moorfields.nhs.uk","quote":"In adjustable surgery, which can be performed in older children and adults, the stitches can be adjusted shortly after the surgery, when the patient is awake.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":1,"max":2,"unit":"weeks","label":"1–2 weeks","source":{"url":"https://www.aao.org:443/eye-health/ask-ophthalmologist-q/can-my-daughter-go-on-amusement-park-rides-after-s","host":"aao.org","quote":"most individuals can resume normal activities around two weeks following surgery","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}},{"id":"muscle-transposition","name":"Muscle transposition","how_it_works":{"text":"The eye muscle is moved to a new 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