Strabismus Treatment Options

The goals of strabismus treatment are to align the eyes, correct double vision, and restore or develop normal binocular vision and depth perception. Treatment plans are tailored to the individual and depend on the type and cause of the strabismus.

Non-Surgical Treatments

In many cases, strabismus can be managed effectively without surgery.

• Eyeglasses or Contact Lenses: This is often the first step, especially if the strabismus is caused by an uncorrected refractive error like farsightedness. Correcting the underlying vision problem can sometimes straighten the eyes on its own.
• Prism Lenses: These special lenses are thicker on one side and bend light before it enters the eye, which can reduce or eliminate double vision for some patients with mild strabismus. They can be clipped onto glasses or ground directly into the lens.
• Vision Therapy (Orthoptics): This is a structured program of eye exercises designed to improve eye coordination and focusing. It's like physical therapy for the eyes and brain, helping them learn to work together. It is most effective for certain types of strabismus, like convergence insufficiency.
• Medication: Certain eye drops or ointments can sometimes be used. In some cases, injections of botulinum toxin (Botox®) can be used to temporarily weaken an overactive eye muscle, helping to align the eyes.

Eye Patching for Amblyopia

If strabismus has caused amblyopia ("lazy eye"), the primary goal is to improve vision in the weaker eye. This is typically done by placing an eye patch over the stronger eye for several hours each day, forcing the brain to use and strengthen the weaker eye. This treatment is most effective in young children.

Eye Muscle Surgery

When non-surgical methods are not effective, eye muscle surgery (strabismus surgery) may be recommended. This procedure does not involve operating inside the eyeball itself; rather, the surgeon adjusts the muscles on the outside surface of the eye.

The surgeon can either weaken a muscle that is too strong or tighten a muscle that is too weak. This is achieved by repositioning the muscle's attachment point on the eyeball. The surgery is typically performed as an outpatient procedure. More than one surgery may be necessary to achieve the best possible alignment. Surgery aims to improve eye alignment and can help restore binocular vision, but glasses or vision therapy may still be needed afterward.