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Eye diseases

Adult strabismus

It can appear in childhood or adulthood.
In many cases, it causes double vision or fatigue.
More and more adults with strabismus decide to have surgery.

What is adult strabismus?

Strabismus is the deviation of one or both eyes, so that each eye looks in one direction, either continuously or only under certain circumstances. It can be convergent (inward deviation), divergent (outward deviation) or even upward or downward. The consequences it entails, which are not only aesthetic but also psychosocial, should not be underestimated, as this eye disease can affect self-esteem as well as personal and professional relationships.

Although it seems like a typical childhood problem and we are used to seeing children turn their eyes away, it is estimated that approximately 4% of the adult population also suffers from it.


If the eye deviation is significant, it becomes aesthetically evident and often entails insecurities, but it can affect vision as well. In fact, in adults with strabismus, (constant or intermittent) double vision is common, which can be very uncomfortable and disabling in everyday life and cause a stiff neck in cases where turning the head results in less double vision. However, in long-standing strabismus with childhood onset, we do not usually find double vision, since the brain ignores the image of the crooked eye and no symptoms appear, except for greater difficulty in calculating distances, perceiving depth, 3D vision or take in the entire visual field.

Adult strabismus has multiple causes. Sometimes it is a pathology with childhood onset that was not treated at the time or was not completely corrected, while in other cases it may have been “latent”, being imperceptible and decompensating for different reasons, such as changes in prescription or appearance of cataracts or different eye diseases.

Among the associated diseases, we can find from diabetes to thyroid alterations or neurological disorders with paralysis of the nerves responsible for carrying signals from the brain (which controls eye movement) to the eye muscles (which carry it out). Likewise, if you have high myopia or have had a problem in the eye orbit, such as trauma or a tumour, you may also develop strabismus.

At the Miranza clinics, we customise treatment based on each patient. In some cases, it is enough for you to wear glasses with the appropriate prescription, or, if your double vision is slight, we can correct it by adapting a special glass that moves the image called a prism. On the other hand, some types of deviation improve with vision therapy, whereas we can try to compensate acute strabismus of recent onset with botulinum toxin. Finally, we can also resort to extraocular muscle surgery, an effective and safe procedure that can be performed at any age, contrary to what many people think.