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Diplopia with normal binocular function is treated with prism glasses, botulinum injections into the muscles, or repeated surgery. If binocular function is not normal, a more individualized approach is necessary to best suit the patient's needs.
Photorefractive keratectomy (PRK) and laser-assisted sub-epithelial keratectomy (or laser epithelial keratomileusis) (LASEK) are laser eye surgery procedures intended to correct a person's vision, reducing dependency on glasses or contact lenses.
Other options for strabismus management are vision therapy and occlusion therapy, corrective glasses (or contact lenses) and prism glasses, and strabismus surgery. The effects that are due only to the toxin itself (including the side effects) generally wear off within 3 to 4 months.
Refractive surgery is optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement.
Surgeons in many specialties commonly use loupes when doing surgery on delicate structures. The loupes used by surgeons are mounted in the lenses of glasses and are custom made for the individual surgeon, taking into account their corrected vision, interpupillary distance and desired focal distance.
Although glasses and/or patching therapy, exercises, or prisms may reduce or help control the outward-turning eye in some children, surgery is often required. A common form of exotropia is known as " convergence insufficiency " that responds well to orthoptic vision therapy including exercises.
For mild conditions, prism glasses can be prescribed to correct specific types of double vision. In more extreme cases, additional intervention such as botulinum toxin injection and strabismus surgery, might be required to rebalance the actions of the extraocular muscles.
Prism lenses (here unusually thick) are used for pre-operative prism adaptation. Eye care professionals use prism correction as a component of some eyeglass prescriptions. A lens which includes some amount of prism correction will displace the viewed image horizontally, vertically, or a combination of both directions.
Low order aberrations (hyperopia, Myopia and regular astigmatism), are correctable by eyeglasses, soft contact lenses and refractive surgery. Neither spectacles nor soft contact lenses nor routine keratorefractive surgery adequately corrects high order aberrations.
Bifocals are eyeglasses with two distinct optical powers. Bifocals are commonly prescribed to people with presbyopia who also require a correction for myopia, hyperopia, and/or astigmatism.