Adult Strabismus

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Can anything be done for adults with strabismus (misaligned eyes)?

Yes. Adults can benefit from some of the same treatment options that are available to children for treating strabismus. Treatment options may include prismatic glasses and surgery. Most adults with misaligned eyes are able to have successful surgical correction [See figure 1]. It is important consult with an eye surgeon who specializes in strabismus surgery.

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 thyroid eye disease, stroke or tumors, but often there is no identifiable cause.

Is eye straightening as an adult strictly cosmetic?

No. Eye alignment surgery is performed in adults for several reasons. Adults frequently have disabling double vision because of eye misalignment. Prism glasses or surgery will likely improve the double vision and depth perception. Heavy prism glasses can be uncomfortable and causes distorted vision, surgery can be evaluated by your surgeon to decrease the dependence on prism glasses.
Also, strabismus affects adults in emotional, social, and economical ways. Realigning the eyes can “reconstruct” the abnormal appearance of the eyes providing a better quality of life.

Does my insurance cover the expense of this surgery?

Eye muscle surgery is reconstructive (not cosmetic). In most cases, insurance will cover strabismus surgery in adults, however, one should check with their medical insurance carrier to determine coverage with their specific plan.

Fig. 1: Adult Strabismus, or misaligned eyes, can be surgically corrected.

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 occurs after strabismus surgery is temporary; however, persistent double vision is possible. Fortunately, the more serious risks are rare. These risks include anesthetic complications, infection, bleeding, retinal detachment, and decreased vision. 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 residual 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. These symptoms typically last only 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 up to 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 option if it is likely to improve symptoms and enhance quality of life. In most cases, eye muscle surgery is a successful, safe, and effective treatment for strabismus in adults of all ages. The good news is that it is never too late for surgery. Even patients in their 90's have benefited from surgical correction.

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.

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.

Updated 11/2016


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