When is the best age for strabismus surgery

For strabismus problems, surgical treatment can achieve good results, but you should also pay attention to choosing the best time, especially for children with strabismus, surgical treatment should be adopted as early as possible for better results.

1. For congenital esotropia discovered after birth or within 6 months, surgery should be performed at 1 to 2 years old before the development of binocular single vision function; esotropia that occurs after 6 months must not be operated on immediately, and the pupil must be dilated for refraction. If there is hyperopia, wear adequate corrective glasses for 3 to 6 months first. If the esotropia is completely corrected, no surgery is necessary and it can be cured by continuing to wear glasses. If glasses are worn for more than 6 months, the esotropia is only alleviated, and the residual strabismus should be operated on as soon as possible. If the strabismus does not change after wearing glasses, surgery should be performed earlier. Monocular esotropia can be treated with occlusion therapy first to induce alternating strabismus, and then surgery can be performed, which is more beneficial for restoring binocular single vision function. If covering for more than half a year is still ineffective, surgical treatment can also be used.

2. Children with exotropia should undergo surgery early, especially for intermittent exotropia. Although there are conservative treatments such as negative lens treatment and convergence training, these methods can only reduce the degree of strabismus and cannot achieve the purpose of cure. The disease is treated with surgery as the first choice, and surgical correction should be performed as early as possible before overt exotropia forms and binocular single vision is completely lost. The best time for surgery is between 4 and 6 years old.

3. The vision of both eyes is normal, and there is no obvious refractive error in the dilated eye test, which proves that wearing glasses is ineffective and surgery should be performed as soon as possible. For intermittent strabismus with very small degree and frequent changes, surgery should be postponed to observe whether it can heal on its own. If the strabismus gradually increases, it will not be too late to perform surgery.

4. In principle, children with strabismus and amblyopia should be treated for amblyopia first and then for strabismus. Only when vision is improved can the effect of surgery be consolidated. However, for strabismus with a large degree, it must be corrected first, otherwise the strabismus eye cannot focus well and the amblyopic eye cannot be treated well. For patients with esotropia or exotropia who have intraocular diseases and whose vision cannot be restored, surgery should be performed after the age of 12 to prevent the loss of binocular vision control and the resulting exotropia or recurrence of exotropia.

5. Children with congenital paralytic strabismus, especially those with compensatory head position, should undergo surgical correction at around 3 years old. For acquired paralytic strabismus, efforts should be made to identify the cause and cooperate with drug treatment. Surgery can only be considered if treatment is ineffective after half a year.