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Diplopia, or double vision, occurs commonly after strabismus surgery. Although the surgery can be used to treat some types of double vision, it can instead end up making existing symptoms worse or create a new type of double vision. [12] The type of double vision can be horizontal, vertical, torsional, or a combination.
Common side effects are double vision, droopy eyelid, overcorrection, and no effect. The side effects typically resolve also within three to four months. Botulinum toxin therapy has been reported to be similarly successful as strabismus surgery for people with binocular vision and less successful than surgery for those who have no binocular vision.
Where appropriate, prismatic correction can be used, either temporarily or permanently, to relieve symptoms of double vision. In specific cases, and primarily in adult patients, botulinum toxin can be used either as a permanent therapeutic approach, or as a temporary measure to prevent contracture of muscles prior to surgery
Following surgery, corrective eyeglasses may be needed, and in many cases, further surgery is required later to keep the eyes straight. When a child requires surgery, the procedure is usually performed before the child attains school age. This is easier for the child and gives the eyes a better chance to work together.
Refractive surgery causes only minimal size differences, similar to contact lenses. In a study performed on 53 children who had amblyopia due to anisometropia, surgical correction of the anisometropia followed by strabismus surgery if required led to improved visual acuity and even to stereopsis in many of the children [9] (see: Refractive ...
Young children with strabismus normally suppress the visual field of one eye (or part of it), whereas adults who develop strabismus normally do not suppress and therefore suffer from double vision . This also means that adults (and older children) have a higher risk of post-operative diplopia after undergoing strabismus surgery than young children.
Those considering laser eye surgery should have a full eye examination. Although the risk of complications is decreasing compared to the early days of refractive surgery, [32] there is still a small chance for serious problems. These include vision problems such as ghosting, halos, starbursts, double-vision, and dry-eye syndrome. [33]
The provider may prescribe an eye patch to relieve the double vision. The patch can be removed after the nerve heals. Surgery or special glasses (prisms) may be advised if there is no recovery in 6 to 12 months. If diplopia turns out to be intractable, it can be managed as last resort by obscuring part of the patient's field of view.