I've been advised to have surgery for strabismus. What questions should I ask the surgeon? Is surgery avoidable?

First and foremost, surgery is not necessary in most cases.

In fact, most cases of strabismus are not caused by problems with the eye muscles, unless resulting from injury. Rather, strabismus is a sensorimotor dysfunction where the brain struggles to coordinate the six pairs of extraocular muscles. It’s one of the binocular vision problems that can be treated effectively at any age through vision therapy. Vision therapy is a non-invasive and highly effective treatment for strabismus. Even in the rare instances where surgery is needed, vision therapy can play a crucial role before and after the procedure to help ensure better outcomes.

Questions to Ask Your Surgeon Before Considering Strabismus Surgery:

  1. Do you expect the surgery to be successful after one procedure, or do you anticipate two or more surgeries will be necessary?

    • What is the likelihood that only one surgery will be required?
    • What is the likelihood that two surgeries will be needed?
    • What is the likelihood that three surgeries will be required?
    • Will the child have improved stereopsis (depth perception) after surgery?
    • What are the potential complications from the surgery?
    • Will the child’s eyes function together after the surgery, or is the goal purely cosmetic?
    • Will my child still need to wear glasses after the surgery?

  2. What are the chances that my child’s eyes will function together normally after surgery? Or is the goal solely for cosmetic improvement?

  3. If the eyes are aligned after surgery, will they remain straight, or is there a chance that the eyes will turn inward or outward later?

  4. Is there a risk that the eyes will look worse after the surgery or that they may deviate in the opposite direction?

  5. If amblyopia (lazy eye) is present, will the surgery improve vision, or will it only straighten the eyes?

  6. Will the surgery improve my child’s binocular depth perception (stereopsis)?

  7. What complications could arise from the surgery (such as infection, risks related to anesthesia, or the need for follow-up surgeries)? What are the percentages of these risks?

  8. Will my child still need to wear glasses after the surgery?

  9. Will the surgeon perform a prism adaptation test (such as one week of testing at home) to assess whether surgery will be successful?

Reference:

For updated science and research on this topic, visit:

https://visionhelp.com/strabismus/

The following books, written by two adult patients with personal experience with strabismus, offer valuable insights. Both authors underwent surgery at a young age but were successfully treated with vision therapy later in life. These books are a source of inspiration for both parents of young children with strabismus and for adults struggling with the condition:

  • “Fixing My Gaze” by Dr. Susan Barry
  • “Cross-eyed Optimist” by Robert Bryan Crockett

These books are particularly helpful for parents and patients:

  • “Crossed & Lazy Eyes: Myths, Misconceptions, and Truths” by Pilar Vergara Gimenez
  • “A Parent’s Guide to Strabismus, Surgery, and Vision Therapy” by Dr. Steven Gallop

All books are available on Amazon.com or OEPF.org.