Adult Strabismus Surgery

Although strabismus, or misalignment of the eyes, is most often treated in children, many adults have a misalignment of the eyes and think that nothing can be done about it.  Many are suffering with double vision that can be remedied by a relatively simple surgery.

Strabismus in adults can develop for many reasons.    Many adults were told as children that nothing could be done for their strabismus.  They have had misaligned eyes their whole lives.  An exotropia, or eye that drifts out, can sometimes be controlled as children.  Adults can lose their ability to compensate for this and their eyes drift.  Some adults simply have poor vision in one eye and this eye turns in or out. Patients with good vision in each eye can see double.  Diabetes and High Blood Pressure can cause temporary Cranial Neuropathies that can cause a temporary misalignment of their eyes.  These patients, in particular, can have double vision that is extremely uncomfortable.  Many of these patients can be helped either with prism or with strabismus surgery.  It can change their lives!

Patients with temporary misalignment of the eyes from Diabetes or High Blood Pressure can be helped by what is called a Fresnel prism. Fresnel stick-on prisms are like old-fashioned colorforms.  They are cut to fit the back of a pair of glasses and can be put on and peeled off when the strabismus is resolved.  Patients are sized based on how severe the strabismus is.  If the strabismus partially resolved, another Fresnel prism can be placed in place of the larger size.  These prisms are helpful in that they resolve diplopia or double vision by tricking the brain into thinking the eye is really straight. They allow patients to have binocular vision until the strabismus is resolved.  The alternative to this treatment is to wear an eye patch to block one eye.  These are often uncomfortable and do remove binocularity.

Patients with good vision in each eye can be tested in the office to see if they are good surgical candidates by placing a prism in front of their eyes.  If the image is double with the prism, they may not be a good surgical candidate.   If the image is not double, post-operative double vision is very rare.  A standard strabismus surgery is done under general anesthesia.  The surgery is typically a nauseating procedure but most anesthesiologists give anti-nausea medications that reduce symptoms.  Most adults experience a little discomfort post-operatively.  I usually tell adults to take a week off from work.  Adults, however, who have this procedure are usually extremely happy.  Recent studies show that misaligned eyes can hinder social interaction, self-confidence and job opportunities.

If you have this problem, feel free to come in for a strabismus consultation!

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