Strabismus is a misalignment of the two eyes: one fixes on the target while the other turns in, out, up or down. In children the brain often suppresses the image from the deviating eye, which can lead to lasting amblyopia. In adults the more common consequence is double vision or the discomfort of an eye that will not hold alignment.
Assessment before any decision
Management starts with a full examination: measurement of the deviation in different positions of gaze, refraction under cycloplegia, assessment of binocular vision and examination of the back of the eye. Some deviations are fully corrected by the right glasses, particularly where uncorrected long sight is driving the turn, and operating in that situation would be a mistake. Others need amblyopia treated by patching before any surgery is contemplated. A squint that appears suddenly in an adult calls for a search for a neurological or orbital cause before surgery is discussed at all.
What surgery can and cannot achieve
The operation works on the muscles that move the eye, weakening or strengthening their action to restore alignment. It improves alignment, sometimes binocular vision, and often confidence and social ease, which is not a trivial reason. It does not restore sight in an amblyopic eye, it does not remove the need for glasses where optical correction is part of the treatment, and an under- or over-corrected result may need a second operation. That possibility belongs in the conversation beforehand.
Points to clarify
Ask which muscles will be operated on and why, what residual deviation would be considered acceptable, how likely a second procedure is, and who will provide orthoptic follow-up near home.