Question:
About: Vision therapy or surgery?
Hi there. When I was 3 I went crossed eyed (my mum thinks it was a bad
reaction to a measles jab). I had one lot of surgery then on the bad eye (left). When I was
5 I had more surgery, this time on the other eye. My left eye has always been lazy and
when I get tired or after exercise I see double. I'm now 29 and about 2 months ago I
noticed 2 images again - pretty much all the time. I went and saw my GP and he referred
me to a specialist who did some tests and then sent me to an orthoptist. She did some
tests with prisms which from what I can see are very subjective - 100% guarantee if I did
the same test tomorrow things would be different. She thought the eye had probably
moved outwards recently. She didn't seem that +'ve about correcting it though. All they
can do is cosmetically fix it by surgery and they can't guarantee the double vision will (a)
go or (b) not come back. The first specialist has now come back and said that the only
option is surgery and he can't even say for sure if they can do this - due to my previous
ops. I've read a lot about vision therapy and managed to track down a specialist in the
UK who will do it. Can it help? My deviation is between 18 and 20% (near and far) -
which from what she said is a lot. The left eye went inward when I was younger but is
now going outward. Comments please. Jason
(Jason Noble)
Answer:
Dear Jason,
Indeed, your only option is surgery. The reason you did not see double previously is that,
as a child, you learned to suppress the image of one eye, and that 's what you did up to
recently, when your eyes started to deviate outward. In general, people that learned to
suppress the images when the eyes were squinting inward can only suppress when the
eyes are squinting inward and people that learned to suppress when the eyes squint
outward can only suppress when the eyes are squinting outward. As you started to see
double recently, the conclusion the eye had probably moved outwards recently is sound.
Have yourself operated, vision therapy does not work in these cases.
Yours truly,
(Herb Simonsz, MD, PhD)
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