Strabismus Surgery
Strabismus Surgery in Encino
Eye-muscle surgery for adults and children, performed by Dr. Benjamin Ghiam, fellowship-trained in pediatric and adult strabismus at the USC Roski Eye Institute.
Is It Time?
Who strabismus surgery helps
Eye misalignment is not just a childhood condition, and it is not something adults simply have to live with.
- Double vision from a cranial nerve palsy that has been stable for 6+ months
- Misalignment from thyroid eye disease, once the disease is quiet
- Childhood strabismus that has returned or worsened in adulthood
- A constant head turn or tilt used to control double vision
- Eye misalignment affecting confidence, work, or social life
- Children with crossing or drifting eyes not controlled by glasses or patching
New double vision in an adult is different: it needs prompt medical evaluation to find the cause, sometimes urgently. Because our surgeons are neuro-ophthalmologists, the cause-finding workup and the surgical repair happen under one roof.
Our Approach
Adult eye misalignment is treatable: it is not too late
Many adults were told decades ago that nothing could be done about their eye alignment, or that surgery would be “purely cosmetic.” Neither is true today. Modern techniques, including adjustable sutures that allow fine-tuning of the result, make realignment effective at any age, and for adults with double vision the benefit is functional, not cosmetic.
The order of operations matters: before any muscle is moved, the cause has to be understood. Nerve palsies, thyroid eye disease, and myasthenia gravis each behave differently, and operating before the measurements are stable is how poor results happen. Dr. Ghiam’s neuro-ophthalmology training means the diagnosis and the surgical plan come from the same discipline.
One honest expectation to set early: strabismus surgery corrects alignment, not focus. If you needed glasses before surgery, you will likely still need them, though prisms often become unnecessary.
What to Expect
From evaluation to stable alignment
- Consultation
Measurements that drive the plan
A full sensorimotor examination with prism measurements, often repeated across visits, because operating on stable, confirmed numbers is what makes results predictable.
- Planning
Which muscles, and how much
Overacting muscles are weakened (recession), underacting muscles strengthened (resection). In selected adults, adjustable sutures allow the alignment to be fine-tuned after surgery.
- Day of surgery
30–60 minutes per eye, outpatient
Children are asleep under general anesthesia; selected adults may choose local anesthesia with sedation. The surgery happens on the surface muscles, with no incision into the eye itself, and you go home the same day.
- First days
Red, scratchy, and normal
Redness and soreness for one to two weeks is expected. You'll use antibiotic and steroid drops and avoid swimming and dusty environments while the surface heals.
- Weeks 1–2
Back to daily life
Most patients return to office work within one to two weeks. Contact sports wait two to four weeks.
- Weeks 6–8
Final alignment
Alignment typically stabilizes at six to eight weeks. If a residual deviation remains, prisms or a planned second adjustment are discussed openly.
Outcomes
What the evidence says
Figures come from published series in our physician-reviewed education library. In those series, 20–30% of patients benefit from an additional procedure, and reoperations are generally successful. Individual results vary with the underlying cause.
Insurance & Cost
Functional surgery, medical insurance
Strabismus surgery is generally performed for functional reasons such as double vision, an abnormal head posture, or loss of binocular vision, and is handled through medical insurance rather than vision plans. Coverage details differ by plan and indication, so contact our office before scheduling and our staff will help you verify your benefits.
When realignment is sought for appearance alone, coverage varies between insurers. We will tell you honestly which category your case falls into at the consultation, before anything is scheduled.
Common Questions
Strabismus surgery questions, answered
Am I too old for strabismus surgery?
No. Eye alignment can be corrected at any age, and adults are often excellent candidates because their measurements are stable. Long-standing misalignment from childhood remains treatable decades later.
Will I be awake during surgery?
Children have general anesthesia. Adults can choose general anesthesia or, in selected cases, local anesthesia with sedation, which also allows adjustable sutures to be fine-tuned.
How painful is the recovery?
Eyes are typically sore, red, and scratchy for one to two weeks: uncomfortable rather than severely painful, and manageable with over-the-counter pain relief.
Will surgery fix my double vision?
Eliminating double vision in your primary, straight-ahead gaze is the central surgical goal, and 80–90% of patients reach a satisfactory result with one operation. Residual deviations can usually be managed with prisms or a second, smaller adjustment.
Will I still need glasses?
Yes, if you needed them before. Alignment surgery does not change the eye's focusing power. Many patients no longer need prism correction afterward, which often means thinner, simpler glasses.
What if the first surgery isn't perfect?
In published series, 20–30% of patients benefit from an additional adjustment, and reoperations are generally successful. Most patients reach their alignment goal within one to two procedures.
Learn More
Read deeper in our education library
The medical facts on this page are drawn from our physician-reviewed patient education library.
Next Step
Get a straight answer about your eye alignment.
Request a consultation with Dr. Ghiam at our Encino office. We see adults and children from Sherman Oaks, Tarzana, Woodland Hills, and across the greater Los Angeles area.