Complex Strabismus Gallery Patient 175110

Adult Strabismus Reoperation for Recurrent Exotropia and Dissociated Vertical Deviation (DVD)

This is already strong clinically, but for a website surgical gallery I'd make it a little more patient-friendly, a little more first-person, and slightly less operative-report in tone while preserving your authority.

Adult Strabismus Reoperation for Recurrent Exotropia and Dissociated Vertical Deviation (DVD)

This gentleman underwent eye muscle surgery as a child because his eyes were drifting outward. As an adult, he came to see me after noticing that the outward drifting had gradually returned. He was also aware that his left eye would occasionally drift upward on its own.

On examination, I found a form of infantile strabismus that had presented primarily as exotropia (outward eye deviation) rather than the more common infantile esotropia (crossed eyes). He also had bilateral dissociated vertical deviation (DVD), a condition in which one eye drifts upward independently of the other. The DVD was significantly more pronounced in his left eye.

Because his original surgery had been performed many years earlier by another surgeon, the exact details of his prior treatment were unavailable. During surgery, I carefully explored the eye muscles and determined that the left lateral rectus muscle had not previously been operated on. I performed a recession of that muscle to address the recurrent exotropia. To correct the substantial DVD in the left eye, I also performed a large recession of the left superior rectus muscle.

The photograph shown here was taken just five days after surgery. Although some redness is expected this early in the recovery process, the improvement in alignment is already evident. Cases like this demonstrate an important point I often discuss with patients: even when childhood strabismus recurs decades later, meaningful improvement is frequently possible. Careful evaluation and individualized surgical planning can often restore alignment and improve both appearance and visual function.

Photos published with patient permission. Individual results vary.