Outcome criteria in strabismus surgery.

Criteria for success in strabismus surgery should include more than just the alignment result in primary position. It is important to consider as well the extent of the field of BSV gained: restoring a useful range of BSV will maximize the patient's ability to carry on daily activities. Psychometric tests can also be used to provide objective measures of improvement following strabismus surgery. Irrespective of the patient's age, the realigning of an eye is reconstructive, not cosmetic, surgery. Surgery in children and adults can restore fusion and normalize the field of BSV in most cases. These gains are possible even in the presence of amblyopia. It could be argued that realigning a blind eye yields no functional improvement and should not necessarily be covered by insurance plans. These cases are not common. In all other cases the functional benefits of adult strabismus surgery justify maintaining insurance coverage for this surgery in jurisdictions throughout North America.