Q: Is strabismus surgery the only treatment option for an eye turn?
Strabismus treatment options depend on the type of strabismus—direction of eye turns, angle of deviations, the presence of convergence insufficiency, double vision, or amblyopia (lazy eye), etc.
Non-surgical treatment such as glasses, prisms, and vision therapy are available, and can lead to improved vision and eye alignment.
Q: Will eye muscle surgery always be successful?
Eye muscle surgery may help to realign the eyes, however, the surgery cannot restore the connection between the eyes and the brain which is vital for vision.
This explains why the eyes often “go back” or deviate again after surgery.
Numerous peer-reviewed scientific studies report success rates for eye muscle surgeries, ranging from 30% to 80%.
In those studies, success is sometimes defined as cosmetic improvement only— the eyes maintained a straight and aligned appearance, but improved vision was not achieved.
Clearly, it is important to determine whether surgery is being recommended for the purposes of cosmetic improvement only.
Q: How many eye muscle surgeries will be needed?
A: Often many surgeries are needed.
If your surgeon has recommended initial eye muscle surgery, ask how many surgeries! The surgeon should be very clear as to the possibility that repeat surgeries could be recommended down the road.
Good cosmetic alignment is often only achieved after two or three surgical procedures are performed.
Q: Can a developmental optometrist be helpful?
Effective surgical intervention to gain the use of both eyes requires not only perfect alignment but also an eye doctor who knows how to stimulate the two eyes to work together! It is therefore often recommended to have a pre- and post-surgical consultation with a developmental optometrist.
Surgery, if necessary, should be coordinated with the developmental optometrist who is knowledgeable in visual development.
If the goal is for improved binocular vision, a developmental optometrist will work to improve binocular vision with the use of lenses, prisms, and Vision Therapy.
During the critical period, if therapy is not initiated immediately following surgery, the chances of success can diminish. Pre-surgical consultation and stimulation by the optometrist are also helpful.
Q: Does the age of the patient matter?
Age does have an impact on whether surgery is appropriate.
Early occurring constant strabismus is the one type of strabismus which might need early surgery to eliminate the eye turn.
For other types of strabismus, especially intermittent, don’t allow a surgeon to rush you into surgery based on statements about age. Surgeons are experts in surgery and may often fail to fully explain all treatment options.
In all cases, we recommend that you seek a second opinion (preferably from an optometrist who offers vision therapy.
Q: Can vision therapy help?
Vision therapy deals with two parts of the visual system:
- Motor- enables the two eyes aim accurately
- Sensory -enables unification of the two images into one 3D image in the brain (stereopsis).
You must have motor control and alignment in order to make the eyes see properly. Often, eye turns that develop before age two, may have good motor alignment without the ability to have stereopsis. If you have an eye turn, it is beneficial to work closely with a behavioral or developmental optometrist to discuss the appropriate treatment methods.
Your child’s binocular vision is essential for meeting all of life’s demands.
If your child has been diagnosed with an eye turn, discuss all of your concerns with your eye doctor.