Can strabismus be corrected if I've had it my whole life?

Yes. Many patients who undergo strabismus surgery have lived with the condition for decades. The surgical techniques and functional benefits — reduced double vision, better depth perception, less eye strain — are achievable at any stage.

Adult Eye Alignment Surgery

Your eyes should
work together.

If you've been compensating — tilting your head, closing one eye, choosing seats strategically — you already know what strabismus costs you day to day. Dr. Malitz has spent over 20 years correcting eye alignment, and he'll tell you exactly what's possible in your case.

20+ yrs

Performing alignment surgery

75%

Aligned after one procedure

Book a Consultation → Call 702-362-3900

You might be a candidate if:

Eye alignment surgery addresses the mechanics of how your eyes work — not just how they look.

✓ You notice one eye drifting inward, outward, or vertically

✓ You experience double vision or have trouble with depth perception

✓ You tilt or turn your head to see clearly or avoid double images

✓ Eye strain or fatigue from your eyes working against each other

Insurance note: Strabismus surgery is a medical procedure and is typically covered by medical insurance, including Medicare.

Understanding the Condition

What's actually happening with your eyes

The medical explanation — plain language, no jargon.

Strabismus is a condition where the eyes don't point in the same direction. One eye may turn inward, outward, upward, or downward — or a combination. The medical term is strabismus, and it's far more common in adults than most people realize.

When your eyes aren't aligned, your brain receives two different images. That mismatch is what causes double vision, difficulty judging distances, and the fatigue that comes from your visual system constantly working to compensate. Many patients have developed habits over the years — a slight head tilt, favoring one eye, sitting on a particular side of a table — without fully realizing they're doing it.

If this has been part of your life for years or even decades, that doesn't mean the window has closed. Strabismus is correctable at any age, and many of the patients Dr. Malitz sees are adults who decided it was finally time to address something they'd been living around.

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Esotropia (inward turn)

One or both eyes turn toward the nose. Often noticeable to others, but the bigger issue is the double vision and depth perception problems it causes.

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Exotropia (outward turn)

One eye drifts outward, especially when looking at distant objects or when fatigued. The most common pattern in adults.

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Vertical strabismus

One eye sits higher or lower than the other. Often causes a compensatory head tilt as the brain tries to align the two images.

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Combined or complex

Some patients have misalignment in multiple directions, or strabismus that shifts depending on gaze position. These cases are more nuanced to correct — surgical experience matters.

How It Works

The surgery, explained plainly

Strabismus surgery corrects alignment by adjusting the muscles that control eye movement. Here's what actually happens.

Isolating the muscle

Each eye has six muscles that control its movement. Dr. Malitz identifies which muscles are pulling too strongly or too weakly and accesses them through a small opening in the conjunctiva — the clear tissue covering the white of the eye. No skin incisions. No visible scarring.

Repositioning or shortening

Depending on the type of misalignment, the muscle is either moved to a new position on the eye (weakening its pull) or shortened (strengthening its pull). This changes the lever action of the muscle so both eyes can point in the same direction.

Fine-tuning (adjustable suture technique)

When Dr. Malitz uses the adjustable technique, the sutures are tied temporarily during surgery. Later that same day, you return to the office where he evaluates your alignment and loosens or tightens the suture until the position is right. Once he's satisfied with the result, the sutures are tied permanently.

Recovery

Most patients experience redness and soreness for 1–2 weeks. You'll use prescription eye drops during healing. Many patients return to work within a few days. The eye typically looks normal within 2–4 weeks.

Why the adjustable suture technique matters

Standard strabismus surgery is a one-step procedure — the surgeon sets the muscles and the position is final. The adjustable suture technique gives Dr. Malitz a second opportunity to fine-tune your alignment after surgery, based on how your muscles respond rather than relying on averages. Not every patient is a candidate for adjustable sutures, but when the technique is appropriate, it can meaningfully improve outcomes.

Honest Expectations

What we tell every patient before surgery

We'd rather you hear this from us now than be surprised later.

📊 The 75% number

Even in the best hands, strabismus surgery achieves well-aligned eyes about 75% of the time after a single procedure. That's the reality of how variable eye muscles are from person to person — not a limitation of the surgeon. We share this number because you deserve to know it before deciding, not after.

🔁 Second procedures happen

About 1 in 4 patients benefit from a second surgery to refine the result. This isn't a failure — it's a recognized part of the treatment process. Some patients have complex anatomy, longstanding misalignment, or muscles that respond differently than predicted. Dr. Malitz will tell you at your consultation how likely a second procedure is in your specific case.

⏱️ There's no "too late"

We've corrected alignment in patients who have lived with strabismus for decades. If you've been told — or assumed — that it's too late to fix, that's worth revisiting. The functional benefits of aligned eyes (reduced double vision, better depth perception, less strain) hold true regardless of how long the misalignment has been present.

🎯 Function and appearance

Some patients come to us primarily because of double vision or eye strain. Others because of how their eyes look. Both are valid medical reasons to pursue correction, and we treat them with equal seriousness. You don't need to justify which one matters more to you.

Non-Surgical Option

Botox® for strabismus: a less invasive approach

Surgery isn't the only path to straighter alignment.

Recent research in ophthalmology has shown that an injection of local anesthetic — with or without botulinum toxin (Botox®) — can produce lasting improvement in some patients with strabismus. The injection temporarily weakens the overactive muscle, allowing the eyes to move toward alignment.

The results are encouraging: approximately half of treated patients maintain well-aligned eyes for as long as three years after a single treatment. This approach may be particularly suited for patients with smaller-angle deviations, those who aren't ideal surgical candidates, or as a first step before considering surgery.

Dr. Malitz will evaluate whether the injection approach, surgery, or a combination makes the most sense for your specific type and degree of misalignment. There's no one-size-fits-all answer — which is exactly why a thorough consultation matters.

Why Southwest Eye Institute

Experience you can measure.

Strabismus surgery is one of the most technically demanding procedures in ophthalmology. The difference between a good result and a great one often comes down to surgical volume and technique.

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AAAHC-accredited surgery center

Your procedure is performed at Red Rock Surgery Center — Dr. Malitz's own AAAHC-accredited, Medicare-certified facility. Same surgeon, same team, same standard every time.

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Adjustable suture technique available

Not every strabismus surgeon offers the adjustable technique. Dr. Malitz does — giving him the ability to fine-tune your alignment after surgery, when it matters most.

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Your surgeon is your doctor

From your first consultation through surgery and every follow-up, you see Dr. Malitz. No handoffs, no rotating providers. One relationship, start to finish.

Common Questions

What patients ask us most

Straight answers, no hedging.

Is strabismus surgery covered by insurance?

Yes. Strabismus surgery is a medical procedure — not cosmetic — and is typically covered by medical insurance, including Medicare and most commercial plans. Our surgical coordinator Brittany will verify your coverage and walk you through any out-of-pocket costs before you commit to anything.

Am I too old for strabismus surgery?

No. There's no upper age limit for strabismus correction. Adults of any age can benefit — the surgery successfully addresses double vision, improves depth perception, and restores natural eye alignment. Many of our patients tell us they wish they'd looked into it sooner.

What is the adjustable suture technique?

During standard strabismus surgery, the eye muscles are repositioned and sutured permanently in one session. With the adjustable technique, Dr. Malitz ties the sutures temporarily during surgery. Later that same day — once you're awake and alert — he evaluates your alignment in the office and fine-tunes the suture tension until the position is right. The sutures are then tied permanently. It's an extra step that gives the surgeon more control over the final result.

How long does recovery take?

Most patients experience redness and mild soreness for 1–2 weeks. The eye typically looks normal within 2–4 weeks. Many adults return to work within a few days. You'll use prescription drops during the healing period, and Dr. Malitz will see you for follow-up visits to monitor your progress.

What if the first surgery doesn't fully correct the alignment?

About 25% of patients benefit from a second procedure. Eye muscles vary significantly from person to person, and longstanding strabismus can be unpredictable to correct. A second surgery isn't a sign that something went wrong — it's a recognized part of the treatment process. Dr. Malitz will discuss the likelihood of needing additional surgery based on your specific anatomy during your consultation.

Can Botox® really improve eye alignment?

In some cases, yes. An injection of botulinum toxin (Botox®) — sometimes combined with local anesthetic — can temporarily weaken an overactive eye muscle and allow the eyes to move toward alignment. Research suggests about half of treated patients maintain well-aligned eyes for up to three years. It's not right for everyone, but for smaller deviations or patients who want to try a less invasive approach first, it's a real option worth discussing.

Will there be visible scars?

No. The incision is made through the conjunctiva — the clear tissue covering the white of the eye — not through the skin. Once healed, there's no visible scarring.

I've had strabismus my whole life. Can it still be corrected?

Yes. Many of the patients Dr. Malitz treats have lived with strabismus for decades — some since childhood. The surgical techniques are the same regardless of how long the misalignment has been present. The functional benefits (less double vision, better depth perception, reduced eye strain) and the cosmetic improvements are achievable at any stage.

Worth a conversation.

A consultation with Dr. Malitz will give you a clear picture of your alignment, your options, and what to realistically expect. No pressure — just an honest assessment of what's possible.