Lazy Eye Surgery For Adults: Is It Worth It? [2023 Guide]

by Florian Wüest • Updated
February 11, 2023
crossed eyes title image

I've had eye muscle surgery in 2019 - as an adult. [1]

Although the eye muscle surgery was done incredibly well by the surgeon (it was minimally invasive) the end results were underwhelming.

On the other hand, I have a handful of friends that have undergone the eye operation and raved about it's results years later.

So... is surgery of your eye muscles worth it if you're an adult?

In this article you'll learn:

You'll not only learn about the science, you'll also learn about a person who had first hand experience trying most of the treatment options available as an adult.

1. Strabismus: The Basics

Before eye muscle surgery is considered, we first have to clear the air about the underlying issue it's aiming to cure: Strabismus, or eye misalignment.

1.1 Why Does Lazy Eye (Strabismus) Develop?

A person with strabismus has misaligned eyes. (Meaning: Both eyes are not pointing in the same direction (either due to muscular issues, or brain issues - or both in summation). [2]

The underlying reason why strabismus develops is not yet clear.

Researchers have identified pre-mature birth as a key risk [3], and genetic reasons as well. [4]

1.2 Is Strabismus The Same As Lazy Eye?

While people often use strabismus and lazy eye simultaneously, they are not the same.

  • Strabismus is the actual phenomena of the eyes not being aligned. Meaning: One eye looks in one direction, the other eye in the other.
  • Lazy eye is 'amblyopia', meaning: The loss of vision in one eye (often caused by the misalignment of the eyes, so due to 'strabismus'). [5]

Approximately 1-4% of the global population is suffering from eye misalignment. [6]

1.3 What Are The Most Common Symptoms of Strabismus?

  • Misaligned eyes: In other words, the eye movement is abnormal in relation to normal vision.

So, one eye looks in one direction - the one eye looks in another.

To people with strabismus, this is socially unpleasant, and makes normal things such a finding a partner more difficult for the patient. As humans have evolved to favor symmetry in their significant others. [7]

This is why the number one reason for surgery in adult strabismus is psychosocial (in plain English, this means for social reasons/ interacting with others). [8]

  • Amblyopia: Strabismus can lead to amblyopia - which means that crossed eyes can lead to permanent blurry vision in the weaker eye. The severe amblyopia (significant loss of visual acuity) is the worst thing that can happen when you have strabismus. [9]
  • Poor depth perception: Which makes it impossible to watch 3d movies. Or makes every day tasks that depend on depth perception, such as parking, more difficult.

Important: This does not mean that people with poor depth perception see the world in 2d. They see it in 3d as well!

Just the visceral sensation of 3d (where the eyes focus and then things 'pop out') is not as clear.

  • Double vision (diplopia): Common symptom of strabismus. However, it is not necessarily the most common symptom of strabismus.

Additionally, double vision can be caused by other conditions, such as neurological disorders or problems with the eye muscles or nerves. Therefore, it is important to consult an eye doctor if you are experiencing double vision or other vision problems. In a complete eye examination, your eye doctor can help you further.

1.4 Can You Get Rid Of Strabismus?

In short: Absolutely. Strabismus is a completely treatable condition. [10]

The earlier it gets diagnosed and treated, the better. Yet even adult strabismus, with the right surgeon, have reported wonderful success rates. [11]

We'll learn more about the most common treatments for strabismus in the next section:

2. Treatments for the Causes of Lazy Eye

Strabismus (lazy eye) can be treated or strongly improved without a surgical procedure. Yet lazy eye surgery is the most common procedure recommended for strabismus.

2.1 How Can You Get Rid Of Strabismus?

Strabismus is a completely treatable condition - yet how can you best fix it?

The only way to fix eye misalignment - is where it originated. We have to train – or force via operative means - both our eyes in the same direction:

  • Surgery works that way: The surgeon forces your eye muscles to pull in the same direction via a procedure called a 'muscle resection' or a 'muscle recession'. This basically means that the surgeon changes the insertion point of the muscle.
  • And so do all vision therapy methods: The Brock String, eye patches, VR Training, various Amblyopia Games – they train your eye muscles to look in the same direction.
  • Prism glasses (almost) do work that way: The glasses change the light rays direction, making sure the light rays hit the right part of the retina. [12]

Lazy Eye: Eye Surgery Cons

Surgery is highly recommended by doctors - yet only 1 out of 20 people that suffer from strabismus opt for surgery. [13]

Why? Because surgery is:

  1. Perceived as 'high risk'. Which is false, as it's a general procedure with minimal complications.
  2. Perceived as 'costly'. Which is right, as the average cost is between $5,000 to $10,000. My out-of-pocket costs were about $4,400.
  3. Perceived as 'painful'. Which is right, as the eye stings for days and weeks after the surgery.
  4. Perceived as 'not necessary'. Which is partially right, as over-and under-correction and re-operation rates are quite common (10%+ in the first year). [14]

Lazy Eye: Eye Surgery Pros

Despite only a small percentage of affected people actually opting for surgery, it's still very wide-spread: 1,2 million strabismus surgeries are done per year in the United States. [15]

Here's why people decide to go for surgery:

  1. The results are quick. You do not have to do months of vision training, instead - you schedule the surgery once and do it. So it's relatively low effort.
  2. The surgery is quick. It's an outpatient procedure (no overnight stay in the hospital) - and you can go in and out of the hospital in about 1-3h.
  3. They decide it's worth it. Given the lack of alternatives, for me personally it was either do I "live my live with crossed eyes" - or do I do something against it? As I looked at it with that perspective, the decision was quite easy.

Strabismus Surgery: Worth It In Adults?

Generally speaking, yes. The risks are generally lower in adults than with infants or children. [16]  So it's merely a question of how high the benefits are.

And the benefits might indeed be less.

Not only do adults have less time ahead than children (given, well, their age) - they also have a bigger inertia due to their previous visual behavioral patterns: If you're used to seeing crossed for a long period of time, it is harder for the brain to re-learn to see properly.

Which could explain the decreased success rate of strabismus surgery in adults. [17]

  • For the average adult, I believe that surgery is a big plus.
  • For me personally though, I would not have done the surgery again. My eyes slipped back into a similar previous position a few weeks later. I got slight improvements, but none as big as I personally hoped for.

3. Are There Alternatives To Surgery?

Surgery is generally an effective, and very safe procedure. However, some of us are prohibited due to the high price tag, risk and time investment (recovery, and meeting with doctors and surgeons).

So generally, surgery is an effective treatment - but it should be a last resort treatment (not the first line).

Nowadays, there are plenty of other treatment strategies. But we believe, none so good as our own Lazyeyefix Ai Software.

I created the software to scratch my own itch after my failed surgery and vision therapy attempts.

The goal of our company Lazyeyefix.com is to offer an effective first-line treatment to everyone suffering from strabismus. It's inexpensive, easy to use - and takes almost no time. We use artificial intelligence to provide an effective, home-based computer vision therapy.

Our software is not a replacement for surgery by any means, but it can help the 19 out of 20 people that do not yet feel ready.

Are you interested in trying out our software? Click the link below to instantly download our software for free.

For Windows: Click Here
For MacOS: Click Here

References:

[1] Minimally Invasive Surgery:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330290/

[2] Strabismus by Cleveland Clinic:

https://my.clevelandclinic.org/health/diseases/15065-strabismus-crossed-eyes

[3] Born Too Soon - The Global Action Report on Preterm Birth by WHO:

http://apps.who.int/iris/bitstream/handle/10665/44864/9789241503433_eng.pdf?sequence=1

[4] Genetic Basis of Congenital Strabismus:

https://jamanetwork.com/journals/jamaophthalmology/fullarticle/817192

[5] The Amblyopia Treatment Studies: Implications for Clinical Practice:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396957/

[6] Prevalence of Strabismus and Its Impact on Vision-Related Quality of Life: Results from the German Population-Based Gutenberg Health Study:

https://www.sciencedirect.com/science/article/abs/pii/S0161642020301913

[7] Facial attractiveness: evolutionary based research:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130383/

[8] Adults with strabismus seek surgery for pyschosocial benefits:

https://www.sciencedirect.com/science/article/pii/S2211505613000793

[9] The Amblyopia Treatment Studies: Implications for Clinical Practice:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396957/

[10] American Optometric Association:

https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/strabismus

[11] Adults with strabismus seek surgery for pyschosocial benefits:

https://www.sciencedirect.com/science/article/pii/S2211505613000793

[12] What Is Prism Correction In Eye Glasses?

https://www.aao.org/eye-health/glasses-contacts/what-is-prism-correction-in-eyeglasses

[13] Strabismus, Strabismus Surgery, and Reoperation Rate in the United States: Analysis from the IRIS Registry:

https://pubmed.ncbi.nlm.nih.gov/29779683/

[14] Strabismus, Strabismus Surgery, and Reoperation Rate in the United States: Analysis from the IRIS Registry:

https://pubmed.ncbi.nlm.nih.gov/29779683/

[15] Surgery is a routine procedure:

https://www.aao.org/eye-health/tips-prevention/lazy-eye-surgery-facts

[16] Conjunctival cysts as a complication after strabismus surgery:

https://pubmed.ncbi.nlm.nih.gov/20795604/

[17] Strabismus surgery - Fact Sheet:

https://visioneyeinstitute.com.au/eyematters/strabismus-surgery-2/

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