Refractive surgery: A treatment for and a cause of strabismus

Purpose of review: The purpose of this article is to review refractive surgery as a means of treatment for strabismus and as a potential cause of strabismus and binocular diplopia. Recent findings: Numerous studies have reported that refractive surgery is effective in correcting certain types of strabismus such as accommodative and partially accommodative esotropia. Studies on the treatment of exotropia related to anisometropia have demonstrated less favorable outcomes. In patients without manifest strabismus preoperatively, recent studies have shown that strabismus and diplopia can occur after refractive surgery. Appropriate clinical testing and risk stratification are essential to determine whether a patient is at increased risk for postoperative strabismus and diplopia. Summary: Refractive surgery can be useful in patients with accommodative and partially accommodative esotropia. A thorough history and clinical examination is extremely important to expose potential risk factors in all patients undergoing refractive surgery. Based on the designated risk level, more advanced testing may be warranted.