Strabismus | Treatments

What are the treatment options for strabismus?

If strabismus is treated early, your child will have a better chance to use his or her eyes together to develop binocular vision and depth perception. It's also important to treat strabismus soon after diagnosis to avoid the onset of amblyopia, which can result in permanent vision loss. 

Mild strabismus

  • Glasses: Your child's eye doctor may prescribe glasses to correct the alignment problem.
  • Patching: Sometimes your doctor may recommend placing a patch over the normally functioning eye for a number of hours every day. "Patching" can help remind the brain that it needs to pay attention to both eyes, which sometimes can improve the alignment.

Severe strabismus

  • Eye muscle surgery is typically needed to straighten the eyes and prevent vision loss when other interventions don't work. 
  • The surgery involves detaching the muscle or muscles that is causing misalignment and reattaching it or them to a new spot.

Botox injections

Very few places in the New England region and in the country offer botox (botulinum toxin A) injections as an option for treatment in children with strabismus. At Boston Children's Hospital, eye doctors can occasionally use botox instead of eye muscle surgery to correct strabismus.

Sometimes, this method proves effective in children for whom surgery has not corrected the misalignment. For adults and older children, this treatment can be given in the office. For young children, the procedure is performed in the operating room with a brief anesthesia but without need for incisional muscle surgery. 

Adjustable sutures in eye muscle surgery

Adjustable sutures allow our ophthalmologists to readjust the position of your child's eye in the recovery room to avoid the need to schedule additional surgery. It may be hard to believe that a child would sit still for the adjustment of adjustable sutures, but our surgical and anesthesia teams perform these adjustments routinely and know how to help a child stay calm and cooperative throughout the process.

If a child is too young or too fearful to cooperate for adjustment, the procedure can be completed with a brief secondary anesthetic in the recovery room without needing to return for surgery. 

What is the long-term outlook for a child with strabismus?

It depends upon the underlying cause of your child’s strabismus, but what is true in all cases is that the sooner the condition is diagnosed, the more effective the treatment will be.