# Strabismus

Source page: https://www.kudretgozistanbul.com/en/treatments/strabismus

**Author:** Opr. Dr. Nail Sönmez | **Medical Approval:** Op. Dr. Mehmet Ali Özdil | **Date:** 2026-09-08

> **Summary:** Strabismus (squint) is when the eyes do not look in the same direction: one eye turns in, out, up or down. It is usually congenital but can develop later, and is treated by correcting the prescription, treating lazy eye with patching, eye exercises and, when needed, surgery on the eye muscles, which can be done at any age.

## Quick Facts
- **Operation Duration:** 30-60 minutes per eye
- **Anaesthesia Type:** Local or general anaesthesia
- **Recovery Time:** 3-4 weeks; eyes stay red for an average of 3-4 weeks
- **Surgery:** On the outer eye muscles; the eyeball is not opened

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## What is Strabismus?
A condition in which the eyes cannot move in parallel or work together: while one eye looks straight, the other turns.

**Types:**
- **Esotropia:** inward turn
- **Exotropia:** outward turn
- **Hypertropia:** upward turn
- **Hypotropia:** downward turn
- **Cyclorotation:** rotation of the eye around its own axis

## Causes
- Genetic factors and family history
- Not wearing glasses that are needed
- Eyelid abnormalities
- Disorders of the eye muscles
- Neurological or congenital conditions such as Down Syndrome or cerebral palsy

## Symptoms
- One eye turning (the most typical sign)
- Head tilting to use both eyes together
- Light sensitivity
- Closing one eye when reading
- Double vision, headache

## False Strabismus
A depressed nasal root, facial asymmetry, eyelid anomalies, unilateral exophthalmos or high myopia can make the eyes look misaligned without real strabismus. Doctors confirm it with light-based tests (symmetrical corneal reflections) and cover tests (no eye movement).

## Lazy Eye (Amblyopia)
Reduced vision that develops when vision is affected in infancy or early childhood; untreated in time, the loss can become permanent.
- **Causes:** strabismus (the turned eye is not used and its vision gradually decreases), an uncorrected need for glasses, congenital cataract, droopy eyelid or other eyelid abnormalities.
- **Symptoms:** often none; it is found at an examination when vision in one eye is lower. If a squint accompanies it, a turning eye may be noticed.
- **Treatment:** correcting the refractive error may be enough alone. Occlusion (patching) of the healthy eye is the most effective method; the earlier it starts the better. Patching is most effective before the age of 7-8 but can also be tried in older children.

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## Treatment
Goals: better visual acuity, straight eyes, correcting abnormal head position and double vision, free eye movements and removing cosmetic complaints.
- Correct the refractive error first.
- Treat lazy eye if present.
- Eye exercises.
- Surgery.

## Price
Treatment varies with the underlying cause; the plan is set after a detailed examination.

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## The Treatment Journey

### 1. During Surgery
- Local or general anaesthesia; 30-60 minutes per eye.
- Eye muscles are tightened or loosened to restore parallel alignment; the eyeball is not opened.
- Self-absorbable stitches; usually no serious scarring.

### 2. After Surgery
- Soreness settles with drops in the first 1-2 weeks; redness fades completely in 3-4 weeks.
- In children, continuing glasses and patching helps keep the result.

## Risks and Possible Side Effects
Risks are low; most side effects are temporary.
- **Redness and mild soreness:** as above.
- **Temporary double vision:** first days, especially in adults; usually disappears within days or weeks.
- **Under or over correction:** corrected with glasses, prisms or a further operation.
- **Infection:** very rare; prevented with prescribed drops and hygiene.

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## Frequently Asked Questions

**Q: Can strabismus be treated in adults?**
A: Yes, surgery can be done at any age. In adults it can reduce double vision and improve appearance, though depth perception that can be gained in childhood may not be fully achieved.

**Q: Is strabismus surgery performed inside the eye?**
A: No. It is done on the muscles on the outer surface of the eye; the eyeball is not opened.

**Q: Can strabismus come back after surgery?**
A: For most patients one operation is enough; in some, a slight turn can return over time and a further correction may be needed.

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## References
- Squint, NHS
- What Is Adult Strabismus?, AAO
- Esotropia, EyeWiki