Unexpected Postoperative Alignment

Abstract

The evaluation and management of strabismus, including strabismus surgery, is not an exact science. Under- and overcorrection, other unanticipated postoperative alignment difficulties, and recurrence following strabismus surgery are not uncommon. There is as much art in the practice of strabismus surgery as there is science, perhaps more. In many cases, the surgeon may elect to intentionally undercorrect or overcorrect a deviation, anticipating slow postoperative drift of the patient’s ocular alignment. The surgeon must be able to recognize when postoperative alignment is favorable or unfavorable and should be able to advise patients on the expected postoperative course. In this chapter, we will review evaluation and management of the patient whose alignment is not satisfactory following strabismus surgery. The chapter is divided into sections based on possible etiologies of unanticipated postoperative ocular misalignment.