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Updated: Apr 26, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Strabismus surgery for children with developmental delay
1aPediatric Ophthalmic Consultants bNew York University Langone Medical Center, New York, USA.
Insights
Surgical correction for strabismus in children with developmental delay is effective, though outcomes vary. Early intervention is encouraged to improve vision and quality of life, with further research needed.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Developmental Pediatrics
Background:
- Strabismus is a common ophthalmologic condition in children with developmental delay.
- Surgical management of strabismus in this population presents unique challenges and considerations.
Purpose of the Study:
- To review current evidence on the surgical approach for strabismus in children with diverse developmental delays.
- To inform clinical decision-making regarding surgical timing, dosage, and treatment type.
Main Methods:
- Review of recent scientific literature on strabismus surgery in developmentally delayed children.
- Analysis of surgical outcomes, variability, and influencing factors.
Main Results:
- Surgical outcomes for strabismus in children with developmental delay show variability, even with dose adjustments.
- Early surgical intervention is beneficial for fusional potential, impacting vision and quality of life.
- Reoperations are more common in this cohort, necessitating careful patient selection and informed consent.
Conclusions:
- Strabismus surgery in developmentally delayed children is generally well-tolerated and effective, but predictability can be reduced.
- Tailoring treatment based on the type and severity of developmental delay and assessing binocular potential is crucial.
- Future research should focus on prospective, comparative, long-term studies with larger sample sizes.
Purpose Of Review:
To describe recent evidence regarding the surgical approach of strabismus in children with various forms of developmental delay.
Recent Findings:
There remains variability in surgical outcomes with or without dose adjustment in strabismus surgery for children with developmental delay. However, this should not deter one from performing surgery - even early surgery, as fusional potential remains possible, which can especially impact the quality of vision and quality of life in developmentally delayed children.Future prospective, comparative, long-term studies with larger sample sizes for strabismus surgery in children with developmental delay are still needed.
Summary:
Strabismus is one of the most common ophthalmologic findings in children with developmental delay. Surgical correction of strabismus in children with developmental delay is well tolerated and effective, although it remains slightly less predictable, which can depend on the specific type of delay or underlying neurological deficit. Careful consideration of types and severity of developmental delay and attempts to measure binocular potential can help guide the timing, dosage, and type of treatment.Reoperations tend to be more frequently encountered in this population, and this higher degree of variability should be addressed in the consent process.Considering adjusting the surgical dosage in this population, taking careful preoperative measurements, and checking for fusional potential should be taken into account when managing children with developmental delay.
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