Strabismus surgery (eye muscle surgery) in Turkey

Surgery is for a deviation that is constant or large enough to matter and that glasses, prisms or exercises do not control. In children that means a turn that persists after any refractive error has been corrected and after amblyopia treatment has begun. In adults it means a turn from childhood that was never treated or has returned, a turn after a nerve palsy, thyroid eye disease or injury, or double vision that prisms can no longer manage.

It is not the first step for every squint. A child whose eyes cross because of long-sightedness often straightens with glasses alone. Small deviations may be handled with prisms in the glasses. Some cases, especially recent nerve palsies, are treated with botulinum toxin injected into a muscle to buy time. And no operation restores the vision of an amblyopic eye or removes the need for glasses; laser vision correction is a different subject for a different problem.

• Constant turn not controlled by glasses

  The typical surgical case in children and adults. Which muscles and how much is decided by measurement, not by how it looks.

• Adult double vision or a return of a childhood squint

  Adults benefit, often with adjustable stitches. Realignment can restore single vision and widen the field of view; it does not restore sight in an amblyopic eye.

• Eyes that cross because of long-sightedness

  Glasses first, sometimes glasses only. Operating before the refractive part is corrected removes too much and leaves the eyes turning outward later.

• Lazy eye without a turn

  Not a surgical problem. Amblyopia is treated by glasses and patching in childhood. Surgery on a straight eye with poor vision does nothing.

Laser surgery does not treat strabismus; for what it does treat, see LASIK in Turkey. Eyes that look misaligned because of drooping lids are a different problem, covered under eyelid surgery, and a squint that appears after cataract surgery or with a cataract is discussed under cataract surgery.

1. 1

   Orthoptic measurement

   The deviation is measured at distance and near, in different gaze positions, with and without glasses, usually on more than one visit. Vision, amblyopia and the ability to fuse images are tested. This is the plan.
2. 2

   Deciding the muscles

   Which muscles on which eye, recession or resection, and by how much. Whether an adjustable stitch is used. Whether one operation is likely to be enough or a staged plan is wiser.
3. 3

   Anaesthesia

   General anaesthesia in children; general, or local with sedation, in adults. Day case in nearly all cases.
4. 4

   The operation

   An incision in the conjunctiva, the muscle detached and re-attached at the new position, dissolving stitches. Under an hour for one eye, longer for both or for several muscles.
5. 5

   Adjustment, if planned

   The next morning, awake, the alignment is checked and the adjustable knot is loosened or tightened, then tied off.
6. 6

   Recovery and re-measurement

   Redness and grittiness for weeks, double vision that usually settles, drops for a period. Alignment is re-measured at weeks and months, because the result is judged when healing is complete, not at the first look.

• Anyone whose squint is controlled by glasses. Operating on a deviation that glasses fix trades a correctable problem for a surgical one.
• Anyone expecting better vision in a lazy eye. Alignment surgery changes where the eye points, not what it sees.
• Anyone who cannot come back for measurement. The result is judged at months and a second operation is a real possibility. A plan for follow-up at home is part of the decision.
• Anyone with an unstable cause. A turn from thyroid eye disease or a recent nerve palsy should be stable for months before surgery, or the operation corrects a moving target.
• Anyone told the result is certain. No honest surgeon promises a single operation and a permanent result in strabismus.

• Number of muscles and eyes. One muscle on one eye is a short operation; several muscles on both eyes is not.
• Adjustable stitch. Adds surgical time and a second visit, and is priced accordingly.
• Anaesthesia and age. General anaesthesia, and paediatric anaesthesia in particular, costs more than local with sedation.
• Pre-operative orthoptic assessment. Whether the measurements and vision tests are included or billed separately.
• Follow-up included. How many post-operative reviews before you fly, and whether remote review of measurements taken at home is offered.
• Re-operation policy. Second operations are common in strabismus. Ask who pays and within what period.

The clinic listing on this page shows each clinic's current price with a note of what it includes. For paying in instalments, see payment plans.