Strabismus surgery and its impact on binocular vision

Strabismus surgery and its impact on binocular vision

Strabismus, commonly known as “crossed eyes” or “eye misalignment,” is a condition where the eyes do not align properly, leading to one or both eyes turning inward, outward, upward, or downward. This misalignment disrupts binocular vision—the ability of both eyes to work together and form a single, three-dimensional image. If left untreated, strabismus can cause double vision, poor depth perception, and even amblyopia (lazy eye). However, strabismus surgery offers a solution by realigning the eyes and significantly improving binocular vision.

In this blog, we will explore how strabismus surgery works and the positive effects it can have on binocular vision.

What is strabismus?

Strabismus occurs when the muscles that control eye movement are not working together. This leads to the eyes focusing on different points at the same time, making it difficult for the brain to fuse the images from each eye. This misalignment can occur in different ways:

Strabismus can be present from birth (congenital) or develop later in life (acquired), and it can affect both adults and children.

Symptoms of strabismus

  • Misalignment of the eyes: Strabismus causes one eye to deviate inward, outward, upward, or downward while the other eye looks straight ahead. This misalignment may be constant or intermittent. The eyes fail to align properly, causing visible imbalance.

  • Double vision (Diplopia): Misalignment leads to conflicting images from each eye, resulting in double vision. The brain struggles to fuse these images into a single picture. This can cause confusion, especially when trying to focus on objects.

  • Difficulty focusing on objects: Strabismus can make it hard to focus both eyes on the same point. This results in blurry or unclear vision, especially for close-up tasks. People may struggle with activities that require steady focus, like reading or using a screen.

  • Poor depth perception: With misaligned eyes, the brain can not merge visual input into a 3D image, impairing depth perception. This makes judging distances or positioning objects more difficult. Tasks like driving or sports become challenging due to inaccurate distance estimation.

  • Eye strain or Fatigue: The brain and eye muscles work harder to compensate for the misalignment, causing strain. Individuals may experience headaches, tired eyes, or soreness. Prolonged visual tasks can worsen these symptoms.

  • Tilting or Turning the head to focus better: To alleviate double vision or misalignment, some individuals tilt or turn their heads. This compensatory behavior helps align the eyes for clearer vision. It is common when trying to focus on objects or read.

How does strabismus surgery work?

Strabismus surgery aims to adjust the eye muscles to bring the eyes into proper alignment. This is done by either tightening or weakening the muscles responsible for controlling eye movement, improving the coordination between the two eyes. The surgery does not remove any part of the eye but instead realigns the eye muscles.

The procedure is typically done under general anaesthesia and may involve either one or both eyes, depending on the type and severity of the strabismus. Patients usually stay in the hospital for a short period and can return to normal activities after a brief recovery.

Impact of strabismus surgery on binocular vision

Strabismus surgery can have a profound impact on binocular vision. Here are some of the key benefits:

Impact of strabismus surgery on binocular vision

1. Improved eye alignment

The primary benefit of strabismus surgery is the realignment of the eyes. Proper eye alignment allows the brain to receive synchronised visual input from both eyes, which is essential for binocular vision. This improvement can significantly enhance your ability to perceive depth and see objects in three dimensions.

2. Enhanced depth perception

Binocular vision enables the brain to combine the slightly different views from each eye to perceive depth. After surgery, many patients experience a marked improvement in depth perception, making everyday activities like driving, walking, and judging distances much easier and safer.

3. Elimination of double vision

One of the most common symptoms of strabismus is double vision. When the eyes are misaligned, the brain has difficulty fusing the images from each eye, resulting in two overlapping images. Strabismus surgery helps eliminate this issue by realigning the eyes, allowing the brain to combine the two images into one clear, focused picture.

4. Improved aesthetic appearance

Strabismus surgery not only improves functional vision but can also improve the appearance of the eyes. By aligning the eyes, the noticeable squint or misalignment may be reduced, which can have positive effects on the patient’s self-esteem and social interactions.

5. Reduced eye strain and Fatigue

Strabismus often leads to eye strain, as the eyes are constantly working to compensate for the misalignment. This can cause discomfort, headaches, and fatigue. After surgery, patients often experience a reduction in these symptoms, leading to a more comfortable and enjoyable visual experience.

Post-surgery expectations

After strabismus surgery, most patients notice improvements in their vision within days to weeks. There might be some temporary discomfort, such as mild redness or swelling around the eyes, but this generally subsides within a few days. Your eye doctor will schedule follow-up appointments to monitor your healing and ensure optimal results.

In some cases, additional treatments like vision therapy may be recommended to further enhance binocular coordination. Vision therapy exercises help the eyes and brain work together more effectively and can improve long-term results.

Conclusion

Strabismus surgery is a highly effective solution for realigning the eyes and restoring proper binocular vision. By improving eye alignment, it can enhance depth perception, eliminate double vision, and reduce eye strain, leading to a more comfortable visual experience. In addition to functional improvements, the procedure can positively impact aesthetics and self-esteem. While recovery is typically quick, ongoing care and sometimes vision therapy may further optimise results. Overall, strabismus surgery offers patients a chance to regain clear, coordinated vision, improving both quality of life and daily activities.

If you are struggling with eye misalignment, do not let it affect your vision any longer. Contact Clarity Eye Surgeons today for a consultation and take the first step toward clearer, more comfortable vision. 

Author bio

Dr Parth Shah is a director and principal ophthalmologist at Clarity Eye Surgeons in Canberra, specialising in strabismus surgery. With extensive training and experience, he is renowned for his expertise in the field. Dr Shah is dedicated not only to performing successful surgeries but also to patient education. His compassionate approach, combined with technical proficiency, has earned him the trust and gratitude of countless patients. He is a true advocate for eye health and a trusted name in the Canberra ophthalmology community.

FAQs

Strabismus surgery can be performed on both children and adults. While it is often done early in life to correct alignment and prevent amblyopia (lazy eye), adults can also benefit from surgery, especially if strabismus develops later in life or as a result of trauma or medical conditions.

Strabismus surgery can correct many types of misalignment, including esotropia, exotropia, hypertropia, and hypotropia. However, the success of surgery depends on the severity and the underlying cause of the misalignment. Some complex cases may require additional treatments or interventions.

While strabismus surgery is generally safe, it does carry some risks, such as infection, bleeding, scarring, overcorrection or undercorrection of the alignment, and changes in the appearance of the eyes. These risks are typically minimal, and complications are rare, but patients should discuss them with their surgeon before proceeding.

Yes. Glasses are needed to correct refractive errors like nearsightedness, farsightedness, or astigmatism. The eye muscle surgery mainly addresses the alignment of the eyes, not the prescription for vision correction. Sometimes the glasses prescription will change after the muscles have been repositioned on the eye. 

While most patients experience significant improvement in vision within a few days to weeks, full recovery may take several weeks to months. It is important to follow the post-surgery care instructions to ensure optimal healing and avoid complications.

In some cases, if the initial surgery does not fully align the eyes, a second surgery may be necessary. This is especially true for individuals with more complex cases of strabismus. Your surgeon will monitor your progress and determine if any further adjustments are needed.

Vision therapy can be an important part of recovery, especially for improving coordination between the eyes and enhancing binocular vision. It may involve exercises to strengthen the eye muscles and improve the brain’s ability to process visual information from both eyes simultaneously.

Strabismus surgery is designed to correct the alignment of the eyes and improve binocular vision, but it does not directly address other visual issues like night vision. If you have difficulty seeing in low-light conditions, additional eye care may be required.

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