Denise wrote:
What are the risks associated with adult strabismus surgery?

I am trying to decide whether to have the surgery. I am 44, and was diagnosed with a misalignment at 1 year. The level of prism in my glasses was stable for many years, but has doubled with each of my last three prescriptions. It is now at about a 13. I am having increasing levels of difficulty with reading, driving, and most other activities. I have also noticed that my posture has changed in an attempt to reduce the double image. I would like an improvement to my vision, but am concerned that my vision may be worse after the surgery. Any information would be greatly appreciated. Thank you.

ANSWER

Dear Denise
The main thing about strabismus surgery is to assess carefully how the two eyes are developed and work together. If both eyes can see clearly (around 20/20) and if a prism can eliminate double image, this could work. However, if one of the eye is severely weakened or if double image is constant, the prognosis for the surgery is not good.  In fact, the surgery will reproduce what you can see through your prismatic glasses. It is never late to compensate for an eye deviation. With age, especially if another surgery was performed in your younger years, it is not uncommon to see strabismus evolve considering that the muscles actions are reduced compared to what it was 20 or 30 years ago. An enhancement surgery is recommended, like in your case, if the increased deviation alters the quality of vision.
Consult an optometrist that specializes in binocular vision and orthoptics in order to get an extensive evaluation of your condition before deciding about the surgery.

Good luck,
Langis Michaud, OD, MSc, FAAO (Dipl) – Associate Professor, École d’optométrie de l’Université de Montréal