Squint correction

Squint surgery is a procedure to correct eye misalignment (a squint). A squint happens when the eyes point in different directions: one eye may look straight ahead while the other turns in, out, up or down.

Surgery involves tightening or loosening the eye muscles to improve alignment, helping the eyes work together to improve comfort and vision. 

Signs of needing squint surgery

In children, a squint may cause lazy eye (amblyopia) or affect how well both eyes work together. Adults may notice double vision, eye strain or reduced depth perception.

At any age, a squint can affect confidence and quality of life.

Is squint surgery right for you?

Surgery may be suitable for adults and children, depending on the type and severity of the squint. Early treatment in children helps prevent long-term vision problems, while adults may opt for surgery if non-surgical options are insufficient or to improve vision and appearance.

Your consultant will review your eye health, overall wellbeing and treatment history, and discuss the benefits, risks and realistic outcomes before recommending surgery.

Alternative treatments to squint surgery

Many squints, especially in children, can be treated without surgery. Non-surgical treatments are usually recommended first. These treatments include:

• Glasses — lenses that correct long or short-sightedness can sometimes realign the eyes
• Eye exercises — certain types of squint, particularly those that appear when focusing close-up, may improve with exercises
• Patching — covering the stronger eye for a few hours a day encourages the weaker eye to work harder, helping improve a squint

If these approaches do not fully correct the squint, or if it is causing ongoing issues, surgery may then be recommended.

Squint surgery is performed under a general anaesthetic. The eye is kept open using a specially designed instrument called a lid speculum and remains in its socket throughout.

Your surgeon will carefully move the muscle attached to the eye into a better position so that both eyes point in the same direction.

The repositioned eye muscle will be secured in place with dissolvable stitches. The stitches are located at the back of the eye and, therefore, are not visible after surgery.

Before the procedure

Before surgery, avoid food and drink for about 6 hours.

When you arrive, the team will guide you through preparation, confirm your medical history, allergies, and medications, and answer your questions. You’ll meet the anaesthetist to review the anaesthetic plan, discuss any concerns, and give your informed consent to proceed.

For children, a parent or guardian can usually stay until the anaesthetic is administered, and a nurse will be at their side throughout the procedure.

Who will be involved?

Your surgery will be performed by an experienced eye surgeon (ophthalmologist), supported by theatre nurses and an anaesthetist. Your care team will be highly trained in paediatric and adult eye care and will ensure you or your child feel safe and well cared for throughout the procedure.

How long does squint surgery take?

The procedure takes around 90 minutes, though this can vary depending on its complexity and the number of eye muscles being adjusted.

Anaesthetic

Squint surgery is carried out under general anaesthetic, so you or your child will be asleep for the entire operation. The anaesthetist will talk you through your options and what to expect.

Pain during and after squint surgery

During the operation, there is no pain, as the general anaesthetic keeps you completely unconscious. After surgery, mild discomfort, soreness, or a gritty sensation is normal. Your care team will provide guidance and medication to help manage your pain.

What to expect after squint surgery

Squint surgery is a day case procedure, so you can go home the same day.

After surgery, it’s normal for your eye to feel tender or look red and slightly swollen, and your vision may be blurry at first. Most discomfort eases within a few days, though mild redness or irritation can last several weeks.

Daily activities can usually be resumed once comfortable, and you can wear your glasses.

Your healthcare team will advise on managing discomfort, using prescribed eye drops, and attending follow-up appointments to ensure recovery is progressing smoothly.

Squint surgery recovery times vary, but most people notice gradual improvement over several weeks.

Short term recovery (first 24 hours)

Immediately after surgery, your eye may feel tender and your vision may be slightly blurry. Rest your eyes as needed. You can read, watch TV, or do light daily activities if you feel comfortable.

Managing your recovery at home

Follow all eye-care instructions, including using prescribed drops and avoiding rubbing the eye. Continue wearing glasses if needed.

Wound care

As the surgery is done internally on the eye muscles, there are no external wounds. Avoid swimming or letting your child play in a sandbox for 4–6 weeks to reduce infection risk.

Pain relief

Mild discomfort can be managed with over-the-counter pain relief. Follow your care team’s guidance.

Smoking

Avoid smoking during recovery, as it may slow healing.

Driving

Avoid driving for a couple of days, or longer if you notice double vision.

Time off work or school

Children may need a few days off school or nursery. Most people can return to work or school after about a week.

What you should/shouldn’t do after surgery

Take care when washing to keep soap or shampoo out of the eye. Avoid wearing eye makeup for 4 weeks. Children should avoid sand play or face paint for the first 2 weeks. You can return to swimming after around 4 weeks and contact sports, such as rugby, after 6 weeks.

Though rare, like any surgery, squint surgery carries some risks, including:

• Double vision
• Eye muscle slipping from its new position
• Prolonged redness (up to 3 months)
• Reaction to antibiotic drops or ointment, causing soreness or redness
• Rare serious complications, including permanent eye damage or excessive bleeding
• Under- or over-eye correction 

As squint surgery is performed under a general anaesthetic, it also comes with the usual risks of general anaesthesia. This includes temporary side effects such as:

• Confusion
• Dizziness
• Headaches
• Nausea
• Vomiting 

In very rare cases, individuals may develop an allergic reaction to a general anaesthetic.