Timing of Strabismus Surgery
Strabismus surgery is rarely an emergency procedure. Accordingly, there is time, and the time should be taken to fully evaluate the condition. On the other hand, it should be remembered that strabismus rarely goes away spontaneously. If anything, there is a general tendency for strabismus to worsen with time—in degree and/or frequency of deviation of the eyes, as well as complications such as loss of vision and binocular capacity. Furthermore, in children, there is a general principle that the younger the child, the more flexible and adaptable is their neurology, including the entire visual system. This can work for both good and bad. The following general approach is therefore recommended. Once the condition has been fully evaluated, the indication for surgery is established and the choice to proceed made, there is no particular advantage to waiting. In certain circumstances, waiting (or delay) may decrease the likelihood of a positive outcome. A second advantage to proceeding with surgery when warranted in children is that older children often worry more and are more anxious about the surgical experience.
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