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The Functional Benefits of Adult Strabismus Treatment

From the Department of Ophthalmology and Vision Sciences, University of Toronto, Ontario, Canada

Correspondence: Correspndence should be addressed to: Stephen P. Kraft, M.D., The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8; e-mail:stephen.kraft{at}sickkids.ca.

Treatment for adult strabismus patients (those above the age of visual maturity, or age 8–9 years) yields many functional benefits. Nonsurgical therapy can address symptoms of diplopia, pain, and asthenopia, as well as torticollis. These modalities include "tincture of time," eye exercises, lenses, prisms, occlusion, and pharmacologic agents.

Strabismus surgery in adults yields many measurable gains, and these can be categorized under: 1) relief of symptoms; 2) regaining of sensory and motor fusion; 3) normalizing the static field of binocular vision; 4) normalizing the field of binocular single vision; 5) improving psychosocial parameters; 6) generating positive cost-benefit analyses. These improvements are possible even when one eye is amblyopic. The cumulative evidence from all of these aspects confirms that adult strabismus surgery is "restorative" or "reconstructive" therapy, and should not be labeled as "cosmetic."

Key words: adult strabismus, functional benefits, strabismus surgery, strabismus treatment