Yes, you can have laser eye surgery if you have a squint, but whether you’re a good candidate depends on the type and cause of your squint, your overall eye health, and your vision goals.
Laser eye surgery can correct refractive errors in people with a squint, but it does not cure the squint itself or fix eye muscle misalignment.
If you’re living with a squint and considering vision correction, this guide will help you understand your options, what laser eye surgery can and cannot do, and what to expect from the process.
What Is Squint (Strabismus) and How Does It Impact Vision?
A squint, also known as strabismus, is a condition in which the eyes are misaligned and do not point in the same direction. One eye may turn inward, outward, upward, or downward, while the other looks straight ahead. Squints can occur all the time or only occasionally, and may involve one or both eyes.
Common symptoms include:
- Double vision
- Poor depth perception
- Eye strain or fatigue
- Decreased vision in one eye (amblyopia, also known as “lazy eye”)
Squints may result from muscle imbalances, neurological conditions, or uncorrected refractive errors. Early treatment is important, especially in children, to prevent permanent vision loss.
Can Laser Eye Surgery Fix a Squint?
Laser eye surgery (like LASIK, PRK, or SMILE) reshapes the cornea to correct refractive errors such as nearsightedness, farsightedness, and astigmatism. It does not correct the underlying muscle or nerve problems responsible for the squint.
- If your squint is related to a refractive error (like accommodative esotropia), correcting the refractive error with laser surgery may reduce the angle of the squint, but it will not cure the muscle imbalance.
- If your squint is due to muscle or nerve problems, laser eye surgery will not fix the misalignment, though it can improve your overall vision.
Who Is a Good Candidate for Laser Eye Surgery with a Squint?
Factors Your Surgeon Will Consider
- Type of squint: Is it constant, intermittent, or only present when tired?
- Underlying cause: Is it due to a refractive error, muscle imbalance, or neurological issue?
- Level of vision in each eye: If one eye has permanent reduced vision (amblyopia), laser surgery will not restore vision beyond what glasses or contacts can provide.
- Binocular vision: Can your eyes work together, or do you have double vision?
- Eye health: Are your corneas healthy and your prescription stable?
When Laser Eye Surgery May Be Suitable?
- You have a mild or well-controlled squint and want to reduce dependence on glasses or contacts.
- Your squint is related to a refractive error, and you’re hoping to improve visual clarity.
- You do not have significant binocular vision problems or double vision that would worsen after surgery.
When Laser Eye Surgery May Not Be Suitable?
- Your squint is the result of a neurological disorder or a significant muscle imbalance.
- You have unstable vision or an underlying eye disease.
- You rely on prism correction in your glasses for comfortable vision—laser surgery cannot replicate this effect.
What Does the Research Say About Laser Eye Surgery and Squint?
A study presented at the Irish College of Ophthalmologists found that refractive surgery (including LASIK and LASEK) is generally safe and effective in adults with strabismus, but careful patient selection is critical. Most patients in the study maintained stable eye alignment and did not develop new double vision after surgery.
Another study concluded that for children with accommodative esotropia (a type of squint linked to farsightedness), LASIK has been shown to improve alignment by correcting the underlying refractive error, but long-term follow-up and careful selection are essential.
What Should You Expect Before and After Laser Eye Surgery if You Have a Squint?
Pre-Surgery Assessment
- Comprehensive eye exam, including measurement of the squint angle and assessment of binocular vision.
- Discussion of your vision goals and expectations.
- Schedule a consultation with both a refractive surgeon and a strabismus specialist, if necessary.
During Surgery
- The procedure is similar to standard laser eye surgery for refractive errors.
- The squint itself is not corrected during the procedure.
After Surgery
- You may notice clearer vision and reduced dependence on glasses or contacts.
- The appearance or severity of your squint will likely remain unchanged.
- If you previously used prism glasses, you may still need a low-power prescription with prism after surgery.
Alternatives and Additional Treatments for Squint
If your primary concern is eye misalignment, your doctor may suggest:
- Eye muscle surgery: Adjusts the position of the muscles to straighten the eyes; often used for moderate to severe squints.
- Vision therapy: Exercises designed to enhance eye coordination and control.
- Prism glasses: Used to align images for comfortable vision.
- Botulinum toxin injections: Temporarily weaken overactive eye muscles in some cases.
Laser eye surgery can be part of a comprehensive treatment plan, but it is rarely the only solution for a squint.
Key Takeaways for Patients with Squint Considering Laser Eye Surgery
- Laser eye surgery can correct refractive errors in people with a squint, but it does not cure the squint or realign the eyes.
- Careful assessment by both a refractive surgeon and a strabismus specialist is crucial for safe, effective treatment.
- If your squint is mild, stable, and not causing double vision, you may be a good candidate for laser eye surgery to reduce your need for glasses or contacts.
- If your squint is severe, unstable, or linked to neurological or muscle problems, other treatments may be needed first.
Your Next Steps
If you have a squint and are interested in laser eye surgery, start with a thorough eye exam and a conversation with both a refractive surgeon and a strabismus specialist.
With the right team and a clear understanding of what laser surgery can and cannot do, you can make the best decision for your vision and eye health. If your goal is to improve eye alignment, ask about muscle surgery or vision therapy as part of your treatment plan. For clearer vision without glasses or contacts, laser eye surgery may still be an option—just be sure your expectations match what the procedure can deliver.
Frequently Asked Questions
Will laser eye surgery cure my squint?
No, it will not correct the muscle imbalance or alignment problem. It can improve vision, but the squint will remain unless treated separately.
Can I have laser eye surgery if I have a lazy eye (amblyopia)?
Yes, but surgery will only give you the best vision possible with glasses or contacts—it won’t improve vision beyond that level.
Is laser eye surgery safe if I have a squint?
Yes, with proper assessment and patient selection, it is generally safe. Your surgeon will check for risks of worsening double vision or decompensation of alignment.
What if I have double vision with my squint?
If you have persistent double vision, laser surgery may not be recommended until the cause is addressed. Your doctor may suggest muscle surgery or vision therapy first.