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Who treats adult strabismus?

An ophthalmologist trained in strabismus is the most qualified specialist to treat adults with misaligned eyes.  Many adults with strabismus wonder, “Why do I go to a pediatric eye specialist? I’m not a child anymore.”  The answer is that misaligned eyes are common in children and ophthalmologists who care for children tend to have the most expertise in treating eye muscle conditions.


How is adult strabismus treated?

Small strabismus that do not cause symptoms may be monitored.  For those with symptoms, treatments include both non-surgical and surgical options.


Prism eyeglasses.

For adults with small strabismus, a prism can be added to glasses to correct double vision.  A prism is a clear, wedge-shaped lens that bends light rays.  It can be added to glasses or be made as part of the lens itself.


Eye muscle surgery.

Eye muscle surgery is the most common treatment for strabismus.  Muscles involved in eye movement can be strengthened, weakened, or repositioned to rebalance how the eyes work together.  Surgery is the best option for large or complicated strabismus.  Adjustable sutures are often used during surgery so that eye alignment may be fine-tuned postoperatively.  Not all patients will need this adjustment.  If needed, the adjustment can be done within hours following surgery, sometimes a day or more later.  Eye muscle surgery is a successful, safe, and effective treatment for strabismus in adults of all ages.


Botox, or botulinum toxin A, is occasionally used in adult strabismus.  Often incisional eye muscle surgery will have a more predictable and more permanent result than Botox.


What are the risks of eye muscle surgery for adults?

Every surgical procedure has some risks.  For strabismus surgery, the most common risks are residual misalignment of the eyes and double vision.  Most double vision that occurs after surgery is temporary; however, persistent double vision is possible and may require further surgery or treatment with prisms.


Fortunately, more serious risks are rare.  These risks include anesthetic complications, infection, bleeding, retinal detachment, and decreased or loss of vision.  Health risks vary depending on your general health.


What should I expect after surgery?

Strabismus surgery is an outpatient procedure.  Most people should expect to return to nearly all normal activities within several days.  More extensive or complex surgeries may require longer recuperation.  Swimming and heavy physical activities should be limited for up to several weeks after surgery.


Discomfort after surgery is usually not severe.  Headache, pulling sensation with eye movement, and foreign body sensation in the eyes are the most common complaints.  These symptoms typically last only several days.  Over-the-counter pain medication is often enough to reduce discomfort, although stronger medication is sometimes prescribed.


How successful is eye muscle surgery?

Most adults, up to 80%, can expect significant improvement in eye alignment with one surgery.  Of course, adults with strabismus is a diverse group.  For those with more complex strabismus, the goal may be to achieve single vision in a straight-ahead position and in the reading position to maximize function.  Sometimes, surgery is only partially successful, or changes in ocular alignment may occur over time after initial success.  Additional surgery is a possibility, as is correction of residual double vision with prism glasses.

To learn more about adult strabismus and its symptoms, please click here

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