Strabismus Surgery

Simply put, strabismus surgery is a procedure designed to improve eye alignment and visual function in patients with strabismus. It is one of the frequently chosen treatment methods for this condition. The surgery aims to reposition the eye muscles in order to achieve better alignment.

What is Strabismus and When is Surgery Needed?

Strabismus is the inability of both eyes to focus on the same point simultaneously. In this condition, while one eye looks straight, the other eye may turn inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia). Depending on the degree of visual impairment, strabismus may be constant or appear only during times of fatigue and stress. It most often begins in childhood but can also occur later in life due to trauma, muscle paralysis, or neurological disorders.
This condition is not only a cosmetic issue but may also lead to functional problems such as eye strain, double vision, headaches, and impaired depth perception. When less invasive options such as glasses, patching, or eye exercises are not effective, surgery may be considered.
In children, strabismus surgery can help realign the eyes and may encourage the brain to use both eyes together. Early intervention is important in reducing the risk of amblyopia. In adults, surgery can provide both functional and cosmetic benefits, contributing positively to quality of life.

Methods and Techniques Used

The main goal of strabismus surgery is to restore parallel alignment of the eyes by repositioning or adjusting the strength of the extraocular muscles. The techniques used vary depending on the severity and type of strabismus.
One of the most common methods is recession surgery. In this procedure, an overactive muscle is weakened and moved backward to reduce its pull.
Another method is resection or plication. Here, a weaker muscle is shortened to strengthen it, helping the eye turn in the correct direction.
In certain cases, both techniques may be applied together—for example, to limit the function of one muscle while strengthening another, especially in severe strabismus.
Among adults, the adjustable suture technique is frequently used. In this method, sutures are left adjustable, allowing the surgeon to fine-tune the eye alignment after surgery while the patient is awake. This approach may provide more precise alignment.
In recent years, minimally invasive techniques have also been introduced. These procedures use smaller incisions to access the muscles, which may shorten recovery time and reduce redness or inflammation.
All surgical approaches are tailored to the patient’s age, type, and severity of strabismus. The goal is not only to improve cosmetic appearance but also to support depth perception and binocular function.

Pre- and Post-Operative Care

Before surgery, the doctor evaluates the patient’s detailed medical history, previous treatments, and current eye examination results. Based on this, an individualized surgical plan is developed according to the type and severity of strabismus as well as the patient’s age. Surgery is usually performed under general anesthesia. The conjunctiva (thin eye tissue) is opened, the target muscle is exposed, and then either shortened and tightened or recessed and loosened. The muscle is secured in its new position with sutures.
After surgery, most patients are able to return to normal activities within a few days. Temporary redness, tearing, or mild discomfort may occur. Prescribed protective eye drops support healing and help prevent infection. Pain relievers may be recommended if needed.
Recovery in children is generally faster, while in adults swelling and redness may last for several weeks. Regular follow-up visits are important to evaluate surgical outcomes and eye alignment. Patience and careful adherence to medical advice can help achieve better cosmetic and functional results.