Can anything be done for adults with strabismus or misaligned eyes?

Yes. Adults can benefit from some of the same treatment options that are available to children for treating strabismus. Recent treatment advances, such as adjustable suture surgery, allow most adults with misaligned eyes to have successful surgical correction [See figure 1].

Why do adults get strabismus?

Adults may have strabismus either from a residual childhood strabismus or they may acquire strabismus in adulthood. New strabismus that develops in an adult can result from conditions such as stroke or tumors but frequently there is no identifiable reason.

Is eye straightening as an adult strictly cosmetic?

No. Eye alignment surgery is performed in adults for several reasons. First, strabismus surgery in an adult may be done to eliminate double vision. Adults may also benefit from improved binocular vision or depth perception. Finally, improvement in the appearance of ocular alignment is sometimes the major impetus for considering strabismus surgery. This should not be considered, however, a “cosmetic” procedure since the surgery is performed to “reconstruct” abnormal ocular alignment. This can lead to significant emotional, social and economic benefits.

Does my insurance cover the expense of this surgery?

Although eye muscle surgery is reconstructive (not cosmetic), one should check with their medical insurance carrier to determine their specific policy.

Is eye muscle surgery risky 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 can develop after strabismus surgery is temporary; however persistent double vision is possible. Fortunately, the more serious risks of anesthetic complications, infection, bleeding, retinal detachment, and decreased vision are rare. Health risks vary with the general health of the individual. For those in poor health, surgery under local anesthesia instead of general anesthesia may be considered.

How successful is eye muscle surgery?

Most individuals have significant improvement in eye alignment with one surgery. Occasionally the surgery is only partially successful, or changes in ocular alignment may occur over time after initially successful surgery.  Additional surgery may be indicated. Correction of double vision may be improved with the use of prism glasses.

How painful is this type of surgery?

Discomfort after eye muscle surgery is usually not severe. Headache, pulling sensation with eye movement and foreign body sensation in the eye are the most common complaints and they can last for several days. Over-the-counter pain medication often reduces the discomfort, although stronger medication is sometimes prescribed. Most patients return to full activity in several days. Some surgeons limit swimming and heavy physical activity for several weeks after surgery.

Is hospitalization required for eye alignment surgery? How will this affect normal activities?

Eye alignment surgery is usually performed as an outpatient procedure although the need for hospitalization varies depending upon general health and surgeon preference. Following surgery most individuals return to nearly all normal activities within several days.

What age is considered "too old" to have eye muscle surgery?

Eyes can be straightened at any age and should be considered as a treatment alternative if it improves symptoms and enhances quality of life.

I am embarrassed by my misaligned eyes and avoid looking people in the eye. It seems to me that people are distracted by my wandering eye causing problems with social interaction and difficulty getting the job I want. Can this really be true?

Yes. Recent studies confirm these observations. Misaligned eyes can hinder social interaction, self-confidence and employment opportunities. All individuals deserve straight eyes if possible.

Who treats misaligned eyes in adults?

An ophthalmologist trained in strabismus is the most qualified specialist to treat adults with misaligned eyes. A specialist can be located in the directory of AAPOS, an organization of eye surgeons with special training in eye muscle problems. Your own eye doctor may also have a recommendation.

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Eye Terms & Conditions