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Outcome criteria in strabismus surgery
1Department of Ophthalmology, Hospital for Sick Children, Toronto, Ont.
Summary
Strabismus surgery success involves more than eye alignment; it includes restoring the field of binocular vision (BSV) for daily activities. This functional improvement, even with amblyopia, justifies insurance coverage for most strabismus surgeries.
Area of Science:
- Ophthalmology
- Surgical Outcomes
- Vision Science
Background:
- Strabismus surgery is often evaluated solely on primary position alignment.
- The functional impact of strabismus extends beyond alignment, affecting daily activities.
- Restoring binocular vision is a key goal, irrespective of patient age.
Purpose of the Study:
- To advocate for a broader definition of strabismus surgery success.
- To emphasize the importance of the field of binocular single vision (BSV) gained post-surgery.
- To support continued insurance coverage for strabismus surgery based on functional benefits.
Main Methods:
- Evaluation of surgical success criteria beyond primary position alignment.
- Assessment of the range of binocular single vision (BSV) achieved.
- Consideration of psychometric tests for objective outcome measurement.
Main Results:
- Restoring a functional field of BSV maximizes patient's ability to perform daily activities.
- Strabismus surgery can restore fusion and normalize BSV, even in cases with amblyopia.
- Functional benefits of strabismus surgery are significant in most cases, including adults.
Conclusions:
- Strabismus surgery success should encompass the extent of BSV gained, not just alignment.
- The functional gains from strabismus surgery justify its reconstructive nature and insurance coverage.
- Even in the presence of amblyopia, strabismus surgery offers significant functional improvements.