Dr Keltner's Editorial1 in the May 1994 issue of the Archives clarified the benefits of strabismus surgery, but he did not sufficiently emphasize how patients with no potential for binocular vision are helped by surgery. It is important to recognize that strabismus is not a cosmetic defect because it is not simply a subjective departure from a patient's concept of beauty and because it is not a natural consequence of aging. Instead, strabismus is the end result of a disease process (namely, defective binocular vision),and it results in a disability (namely, the loss of normal eye contact with others). Thus, strabismus is a deformity, much as an extra finger on the hand or a benign neoplastic mass on the face is a deformity.
Dr Keltner noted that strabismus may have serious psychosocial complications. Unfortunately, medical "gatekeepers" are not likely to be sympathetic to a discussion of psychology. Instead, it should
Hunter DG. Benefits of Strabismus Surgery in Patients With One Blind Eye. Arch Ophthalmol. 1995;113(4):404. doi:10.1001/archopht.1995.01100040018007