Ana Wert: "More and more adults are undergoing strabismus surgery."

Strabismus is a very common eye problem, consisting of a persistent or occasional deviation of one or both eyes. It can appear before six months of age—known as congenital strabismus—during childhood, or, in some cases, in adulthood, due to poor control of eye muscle movement by the brain, a refractive error, low vision, or a muscular abnormality, and, more recently, due to excess eye movement. Although early diagnosis and treatment of strabismus are most advisable so that it does not affect visual development in childhood, Dr. Ana Wert, an ophthalmologist specializing in strabismus at the IMO Grup Miranza, explains that adult patients should not resign themselves to living with this problem.

Can strabismus be treated at any age?

— Yes, there's a misconception that strabismus can only be treated in childhood, but that's not true. We operate at any age. At our center, we perform strabismus surgery on infants and young children, all the way up to people in their 70s and 80s..

What are the most common questions patients have?

— We often see patients who think their problem is unresolvable or won't improve, and they aren't receiving the treatment they need. Some people who have already had surgery also think they can't opt for surgery again if the progression of the disease requires it, but that's not the case. Another common myth is the fear of seeing double vision after strabismus surgery, which is a very rare complication. In fact, this operation helps resolve the problem of double vision before surgery, which occurs when strabismus appears in adulthood and can be very limiting for driving and other daily activities.

What causes these confusions?

— This is probably due to not having consulted an expert in this type of procedure. Strabismus requires a highly specialized approach.

Is there any option to avoid surgery?

— Surgery isn't the only treatment option. There are different types of strabismus, and therefore, different options that must be personalized by evaluating the patient during the ophthalmologist consultation.

What does the surgery consist of?

— If surgery is required, we normalize the position of the eyes to correct the loss of parallelism between them or ocular deviation. This way, we ensure they work together in a coordinated manner. It is an outpatient, extraocular procedure, meaning we do not enter the eye itself; we only manipulate the muscles surrounding it, which are responsible for gaze direction. The results are fairly immediate, and the patient already notices changes upon leaving the operating room.

Does strabismus evolve over the years?

— It's an active process, so a person with strabismus can experience ups and downs. Furthermore, after a certain age, when presbyopia (eye strain) sets in and the lens of the eye doesn't function as well as it used to, strabismus tends to spiral out of control. Patients usually notice it most at the end of the day, when they're most tired, or when they strain their eyes more, such as driving or performing other tasks that require concentration.

It is often thought of as purely cosmetic surgery...

— This is another very common myth, but it's a reconstructive and functional surgery. It's clear that the patient's eyes will improve and change their appearance, but at the same time, they will also improve their perception and location of objects and their visual field. Furthermore, we can minimize or correct some symptoms associated with strabismus, such as diplopia (double vision), eyestrain, photophobia, headaches, and torticollis, among others.

What effects do operated patients report?

— Surgery has a significant impact on improving quality of life, and in this regard, what patients highlight most is a side effect: improved personal relationships. People who undergo surgery and have their strabismus corrected typically experience greater self-confidence and social skills.