Strabismus treatments and operation

Ophthalmological clinic for strabismus operation in Madrid


At the Martínez de Carneros Clinic we are specialists in treatments and operation of strabismus. We invite you to find out more about this pathology in our article and also go to the ‘Medical Team’ section and meet our specialists in strabism for adults, infants and babies.


Strabismus, or tropia, is that deviation of the alignment of one of the two eyes with respect to the position of the other so it does not allow the patient to have a bifoveolar fixation.

This condition causes the decrease or possible annulment of what is technically known as stereopsis, i.e. 3D vision or depth perception of objects and images.


There are several types of strabismus and the classification can be divided mainly in the direction of the deviation and the cause of its appearance.

Therefore, we would speak of exotropy (XT) when the deviation is in the horizontal axis and towards the temporal zone and, an endotropy (ET) if the deviation is directed towards the nasal zone. In cases where the deviation in the vertical visual axis is deviated upwards, it is called hypertropy (HT).

According to the causes, strabismus can be:

  • Congenital strabismus, which is the most common. It develops during childhood and the visual impairment is amblyopia (lazy eye).
  • Acquired strabismus, usually due to trauma, neurological problems, or diseases such as diabetes or hyperthyroidism that cause the patient diplopia (double vision), something quite incapacitating for his life.


Existing treatments for correct strabismus are many:

  • Correction with glasses or contact lenses: is usually the first choice. A prism can be added, which is an element that compensates for deviation. Normally accompanied by treatment of occlusion (opaque patch) or visual penalization (translucent patch) of the non-amblyopic or non-lazy eye.
  • Botulinum toxin: is another technique for treating strabismus, sometimes the only possible alternative. This method requires topical anesthesia in adults, and general anesthesia and hospitalization in the case of children. Botulinum toxin injection aims to correct eye deviation and try to reduce the chances of undergoing surgery. The technique consists of injecting a product that temporarily paralyzes the affected muscle or muscles.
  • Strabismus surgery : in many cases strabismus surgery is the most suitable treatment. In this case we are talking about surgery treatment where it is important to know the next steps that the patient will go through.


  • First consultation: the patient will be attended, in a first moment, by our optometry team and they will evaluate the visual function in the clinic.
  • Second consultation (same day): the strabismus doctor will complement these tests with the study of motor and sensory visual function. It is advisable, as in any other consultation for information on surgery, to come accompanied, as the possible intervention is explained to the patient and it is necessary in most cases to dilate the pupil, which leads to blurred vision for a few hours.
  • The surgery: that we explained in the following point.


The first thing the patient should know about strabismus surgery is that it is performed in the external area of the eye and that anesthesia conditions vary depending on the age of the patient.

Strabismus surgery on children up to 10 years old is usually performed under general anaesthesia because children under this age tend to have a lower collaboration and prevent anaesthetic drops from penetrating the eye, which requires postoperative hospitalisation for a few hours. In the case of strabismus operation in adults surgery is usually performed under topical anesthesia.

The objective of the intervention is basically to weaken and/or strengthen the muscles that move the eye in the different eye positions so that there can be an alignment of the visual axes in those eye positions where the deviation exists.

Usually only the deviated eye is intervened, but in some cases surgery of the muscles of both eyes is necessary since the movement can be enhanced with the antagonist muscle or synergy of the affected eye. The number of muscles to be operated on depends on the type of strabismus and the deviation.

Surgery significantly improves aesthetic problem , binocularity as well as torticollis but in many cases no improvement in vision and in these cases the result is complemented with other treatments previously mentioned.

operación estrabismo


If the surgery is not performed when the doctor needs it, we could miss the opportunity for the patient to gain visual acuity in addition to the aesthetic and psychological problem.

It is necessary to know that the deviation can remain stable, increase or decrease, although this last option is the least frequent. When the best option indicated by an ophthalmologist is to perform surgery, the ideal is to access this intervention and place ourselves in the hands of medical professionals specializing in strabismus.

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