Eye SchoolUrgent

This site provides general eye-health education. It cannot replace individual assessment by a registered doctor, and does not offer personal diagnosis, prescriptions, bookings, sales or referrals.

If translations differ or are incomplete, the Traditional Chinese (zh-Hant) text on this site prevails.

Lens and refraction · AN

Strabismus surgery

Pre-op assessment · indications education · post-op red flags

Last reviewed: 2026-10-06 · 潘家健醫生

Key points

  • Strabismus surgery adjusts extraocular-muscle insertion or force — education, not a success-rate chart.
  • Preoperative assessment is specialist-led; amblyopia and emergency flags are on the strabismus page.
  • Sudden severe pain, vision drop, heavy pus-like discharge or fever after surgery: A&E now (call 999 if needed).
  • Do not self-add leftover steroid drops.

What it is

Strabismus surgery adjusts extraocular muscle insertion or pull to improve alignment and some diplopia. This page is public education about surgery — not a booking menu or success-rate comparison. When to seek care, amblyopia and emergency flags are on the strabismus-and-amblyopia page; TED rehab order is on the thyroid-eye-disease page.

Classification reminder (see the strabismus page)

  • Constant vs intermittent; eso / exo / vertical
  • Accommodative vs non-accommodative; paralytic vs restrictive (e.g. thyroid eye disease)

Pre-operative assessment (what a doctor / orthoptist may do — not a DIY kit)

  • Prism cover testing, control, distance and near measurements
  • Hess chart or similar motility mapping in selected cases — interpreted by the examiner

When surgery may be discussed (education, not a guarantee)

  • Constant strabismus, or intermittent exotropia with poor control affecting life or appearance
  • Selected paralytic cases with diplopia that persists after a conservative wait
  • Marked abnormal head posture; timing of infantile strabismus is a specialist decision
  • Treat amblyopia first when needed, then discuss surgical timing
  • Surgery can improve alignment and some diplopia; stereo recovery is not guaranteed

Surgery aligns what remains after an appropriate glasses prescription. A hyperopic / accommodative component usually still needs glasses; do not expect “surgery means no glasses”. Whether glasses continue is decided at follow-up.

Technique as classes

  • Recession, resection / shortening, transposition — chosen from measurements and goals
  • Usually under the conjunctiva; this page makes no skin-scar or cosmetic promise
  • Adjustable sutures are a technique some surgeons use in selected cooperative adults — not a menu tick-box and not a guarantee of greater accuracy. Use is decided by the surgeon for the case.
  • No public millimetre-per-prism-dioptre dosing tables (operator protocol, not education)

After surgery

Redness and foreign-body sensation are often expected. Any post-op antibiotic or steroid drops are prescribed only by the operating surgeon; this page lists no drug names and gives no times-a-day or weeks schedule.

Undercorrection or overcorrection can occur; some people need further surgery or temporary prism. Short-term diplopia after adult surgery is common; most improve as swelling settles or the brain adapts, but disappearance is not guaranteed. Long-term diplopia and whether re-operation is needed can only be explained in person.

Sudden severe pain, rapid vision drop, copious pus, corneal haze or fever after surgery: exclude infection or anterior-segment ischaemia — go to A&E now (if you cannot get there: call 999). Infection is uncommon but sight-threatening. Do not add leftover steroid drops on your own.

TED rehab sequence

In inactive thyroid eye disease, staged surgery is taught as orbital decompression → strabismus surgery → eyelid surgery. See the TED page.

This is general medical information, not a diagnosis, and cannot replace an in-person consultation with a registered ophthalmologist, refraction, or a dilated fundus exam. It is not advice to use any medicine or undergo any procedure. Medicines (including off-label use), laser or surgery must be decided by a registered doctor after examination, according to indications and Hong Kong registration. Figures from the literature are published averages, not any clinic’s results. This site does not book, prescribe or refer. Do not change treatment on your own.