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Postgrad Med J 87:269-273 doi:10.1136/pgmj.2010.108670
  • Review

The efficacy of strabismus surgery in adults: a review for primary care physicians

  1. Burton J Kushner
  1. Pediatric Ophthalmology & Adult Strabismus, John W & Helen Doolittle Professor, Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison, USA
  1. Correspondence to Burton J Kushner, University of Wisconsin, 2870 University Avenue, Suite 206, Madison, WI 53705, USA; bkushner{at}wisc.edu
  • Received 24 August 2010
  • Accepted 26 November 2010
  • Published Online First 27 January 2011

Abstract

Many adult patients with strabismus are under the misconception that nothing can be done to correct the problem or that treatment is associated with a high degree of risk. Moreover, many optometrists, comprehensive ophthalmologists and primary care physicians are similarly misinformed. In fact, most adult patients with strabismus can be successfully treated, with ∼80% of patients achieving satisfactory alignment with one surgical procedure. In addition, adult strabismus surgery carries a relatively low risk, with serious complications being anecdotal and rare. The majority of adults will experience some improvement in binocular function after strabismus surgery even if the strabismus has been longstanding. Most commonly this takes the form of an expansion of binocular visual fields; however, some patients may also regain stereopsis. Consequently, strabismus surgery in adults is not merely cosmetic in most cases. There are many psychological and interpersonal benefits to adult strabismus surgery. These benefits are highlighted by the finding that the majority of adults with strabismus would trade a portion of their life expectancy to be rid of their ocular misalignment. Although adult strabismus surgery has been shown to be highly cost-effective, many adults with strabismus can be successfully managed by non-surgical means. If an adult with strabismus is under the impression, or was told, they cannot be treated, or that treatment is risky, they should consider a referral to an ophthalmologist specifically specialising in strabismus.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.


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