We are now open, with safety as our top priority. Click to learn more.

Conditions & Treatments

Eye Muscle (Strabismus) Surgery

What is Adult Strabismus?

Adult strabismus is a visual problem where the eyes do not simultaneously align together, and instead point in different directions. It may affect one or both eyes. Strabismus is frequently considered to be a childhood problem affecting about 5% of children. However, strabismus affects about 4% of adults in the US. It results in visual, physical and psychosocial disabilities. In the worst cases, it can affect an adult’s independence. Whether it is new-onset or recurrence of childhood strabismus, it can often be successfully treated with surgical and nonsurgical options, depending upon the severity of strabismus.

There are several categories of adult strabismus, or misaligned eyes: childhood-onset strabismus that was never corrected, or adult new-onset strabismus caused by orbital or head trauma, stroke, a brain tumor, orbital inflammatory disease, thyroid eye disease or other neurological or eye conditions.

What causes strabismus?

Strabismus is a condition caused by eye muscle dysfunction as a result of problems with the eye muscles, the nerves that transmit information to the muscles, or injury or disease to the part of the brain that controls movements. It may result from circulation problems, neurological problems, strokes, tumors, diabetes and hypertension, certain medical conditions, or head injury, and nerve damage due to injury or disease.

What are the symptoms?

  • Double vision or diplopia. Diplopia is disorienting and can be debilitating causing a reduction or inability to read, drive or perform daily life activities. Restoring alignment relieves double vision.
  • Visual confusion. Visual confusion is where the brain perceives two images in the same space. This is particularly dangerous when driving.
  • A loss of binocular vision. This is a loss of depth perception.
  • A reduced visual field. This is a loss of peripheral vision.
  • Abnormal head posture. Strabismus can cause the person to tilt or turn the head in an attempt to reduce double vision.
  • Headache
  • Eye strain
  • A small or large eye misalignment which is usually seen as crossed eyes or an eye that drifts out.
  • A negative quality of life. Because of the inability to maintain normal eye contact, strabismus can negatively impact the person’s ability to obtain a job, receive a promotion, or find a partner. This can lead to depression, anxiety and social avoidance.

How is strabismus diagnosed?

There are six muscles that control eye movement. To focus with both eyes on a target the muscles in each eye must work together. Your Union Square Eye Care ophthalmologist or optometrist will review your complete medical history and conduct an examination. This will include visual acuity (reading the eye chart), refraction, alignment and focus tests. Your eyes will be dilated to view and evaluate the health of the internal eye structures.


Strabismus can often be treated with eyeglasses, prisms, Botox injections or eye muscle exercises. Eye re-alignment surgery is outpatient surgery to reposition, strengthen or weaken the eye muscles. Adult strabismus surgery may involve the use of adjustable sutures to allow for adjustments after surgery for fine tuning. Pain is usually minimal and can be treated with over the counter pain medications if needed.

When surgical correction is indicated, it will be performed by one of the world’s leading authorities on pediatric and adult strabismus correction at Union Square Eye Care in Manhattan.

A leading world authority on adult strabismus

No one, adult or child, should have to live with this condition or the vision problems that may accompany it. Now, thanks to board-certified ophthalmologist H. Jay Wisnicki, MD, adult strabismus is correctable at any age. Dr. Wisnicki is world-renowned for his work with pediatric and adult strabismus. In each case, he adjusts the tiny muscles that control eye movements with great skill and precision until both eyes are able to move and track together normally.

It’s never too late for correction

You can be confident knowing that our ophthalmic surgeons perform strabismus correction at accredited eye surgical centers that put your comfort, safety and convenience first. You’ll also feel confident knowing that a some of the world’s leading ophthalmologists are on the Union Square Eye Care team. To learn more about how we can correct misaligned eyes, call and schedule your personal consultation at our office today.

End of content dots
Schedule Appointment