Adult eye misalignment and surgical correction
Strabismus (Eye Misalignment)
What is Strabismus (Eye Misalignment)?
Strabismus is a condition in which the eyes are not properly aligned — one eye may turn inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia). While commonly thought of as a childhood condition, strabismus also affects adults. It can develop from previous childhood strabismus that recurs, from neurological conditions, after trauma, or from age-related changes in the eye muscles. Adult strabismus surgery realigns the eyes by adjusting the position and strength of the eye muscles, and is performed as an outpatient procedure.
Symptoms
- Visible misalignment of the eyes
- Double vision (diplopia)
- Difficulty with depth perception
- Eye fatigue and strain, especially with reading or screen use
- Head tilting or turning to compensate for misalignment
- Social self-consciousness about eye appearance
Diagnosis
A comprehensive strabismus evaluation includes measurement of the degree and direction of misalignment in multiple gaze positions, assessment of eye movement range, and evaluation for underlying neurological causes. Prism measurements quantify the deviation precisely. In some cases, imaging of the eye muscles (CT or MRI of the orbits) may be helpful, particularly if restrictive or neurogenic causes are suspected.
Treatment
Treatment options depend on the type and severity of strabismus. Prism glasses can compensate for small misalignments. For larger or symptomatic misalignments, surgery is the definitive treatment. Strabismus surgery involves adjusting the position of one or more eye muscles to realign the eyes. The procedure is performed under general anesthesia as an outpatient surgery, with most patients returning to normal activities within one to two weeks. Benefits include improved binocular vision, restored depth perception, cosmetic improvement, and reduced double vision.
Why See a Neuro-Ophthalmologist?
Dr. Ghiam has specialized fellowship training in both neuro-ophthalmology and adult strabismus surgery. This dual expertise is particularly valuable for patients whose strabismus has a neurological cause — such as cranial nerve palsies, myasthenia gravis, or thyroid eye disease — where understanding the underlying condition is essential to planning the right surgical approach.
Strabismus Surgery Results
Before and after photographs demonstrating eye realignment following adult strabismus surgery performed by Dr. Ghiam.
Frequently Asked Questions
Concerned About Strabismus (Eye Misalignment)?
If you or someone you know is experiencing symptoms, early evaluation by a neuro-ophthalmologist can make a significant difference in outcomes.