Adult Strabismus

What is strabismus?

Strabismus, or misaligned eyes, can cause the eyes to deviate in many directions – eyes can either be crossed in, drift out, or one may be higher than the other.  Typically, strabismus in adults is a result of childhood strabismus that was not treated or progressive strabismus from injury or disease like thyroid, stroke, or diabetes.  In the past, people used to think that strabismus was only a “cosmetic problem” however, there is now a growing awareness that this is not the case.   Strabismus can affect social interactions and surgery has been shown to improve depth perception, self-esteem and even distance and reading vision.  Often times, adults will have double vision, or diplopia, as a result of their strabismus.  Most insurance carriers will cover strabismus surgery since it is considered a reconstructive surgery, though you should check with your individual carrier.

There are many different types of treatments for adult strabismus.  Glasses with prism or BOTOX® injection can sometimes alleviate the problem altogether, though, usually eye muscle surgery is required.  During eye muscle surgery, the culprit muscles are either weakened or strengthened to result in straight eyes. At Honolulu Eye Clinic, we offer adjustable suture strabismus surgery for adults.  This type of surgery is ideal for patients who have had re-operations in the past, or for those who have double vision from their strabismus.  It allows for a fine-tuning of the surgery in the recovery room, since the eye muscle is placed on a “slip knot” and adjusted when the patient is awake, thus greatly reducing the chance of post-operative double vision. 

Below are commonly asked questions
regarding adult strabismus:

I’m already an adult, is it too late for me to have strabismus surgery?

No, it is never too late to have strabismus surgery.  I have operated upon adults well into their late 70’s!

Is strabismus surgery risky?

The risks of the surgery are related mainly to the minimal chance of double vision after the surgery or that one surgery sometimes is not enough to align the eyes.  The surgery, itself, is on the muscles of the eye and not inside the eye like cataract surgery, so there is a much lower risk of causing loss of vision.  Other than that, the standard risks of general anesthesia apply.

Does strabismus surgery hurt?

Some patients will report feeling “sand” in their eyes for a few days after the surgery. Usually, most pain can be treated with over the counter pain medicines.

Does the adjustment in the recovery room hurt?

Again, this varies by patient. Most patients will not report any discomfort during the adjustment, but will feel a “tugging” sensation while the adjustment is being performed, since you are awake. 

For a full strabismus evaluation, please call to
make an appointment with Dr. Rupa Wong