Skip to main content

Ophthalmology · UK

Squint surgery - the decision, not just the operation.

The right decision about squint surgery is often not to operate yet. This is the framework a strabismus surgeon uses across children and adults - when to move, when to wait, and when to reach for glasses, prisms or botulinum toxin instead.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private squint surgery costs in the UK.

Indicative ranges across our partner UK units.

In short

£4,500–£7,500, home the same day.

Procedure Indicative range
Two-muscle squint surgery £4,500–£7,500
Bilateral squint surgery £5,500–£9,000
Adjustable-suture squint surgery £5,500–£9,500
Revision squint surgery £6,000–£10,000
Botulinum toxin for squint £950–£1,800
Prism prescription and trial £150–£300
Paediatric orthoptic assessment £180–£320
Strabismus consultant clinic £280–£450

Prices vary by consultant, by whether one eye or both, by whether adjustable sutures are used, and by whether it is a first or revision operation.

The problem

A decision that spans childhood and adulthood.

Squint is not one condition. A congenital esotropia in a two-year-old and an acquired exotropia in a fifty-year-old share only the name - the framework for deciding whether and when to operate is different.

  • Function before appearance

    For children, protecting binocular vision and preventing amblyopia is the first priority. Cosmetic alignment follows.

  • Glasses first, always

    A refractive correction sometimes cures the squint. Any surgical decision comes after a full glasses trial.

  • When to wait, not to operate

    Some squints improve. Some are better with prisms. Some need botulinum toxin first. Surgery is one option in a menu.

When it helps

When squint surgery is the right step.

The situations we see most, plus the one red flag that means urgent review rather than a routine booking.

  • Congenital squint in a young child

    Constant infantile esotropia is usually operated between 12 and 24 months - protecting binocular development.

  • Accommodative squint on glasses

    Sometimes glasses alone remove the squint entirely. A period of stable glasses use comes before any decision to operate.

  • Intermittent exotropia

    Divergent squint that becomes constant, or causes symptoms in a school-age child - surgery on the measured constant angle.

  • Adult cosmetic squint from childhood

    A childhood squint that was never operated - often a single operation with good cosmetic results.

  • Sixth-nerve or third-nerve palsy

    Once stable for 6–12 months, targeted surgery or a transposition procedure.

  • Thyroid eye disease post-decompression

    Once thyroid function is stable and orbital decompression complete, extraocular muscle surgery for residual restriction.

  • Diplopia after cataract or retinal surgery

    Persistent double vision after major eye surgery - targeted alignment for the specific angle.

  • Red flag: new squint with neurology

    A new squint with headache, neurological signs or vomiting needs urgent neurology and imaging.

Procedure options

Surgery is one option - here are the others.

Alternatives and complements to surgery, and the specific situations each fits.

  • Full glasses trial first

    A trial of the correct refractive prescription - sometimes the entire treatment.

  • Prism spectacles

    Prisms in glasses fuse small angles without surgery, and are ideal in adults where the angle is small and stable.

  • Orthoptic exercises

    Convergence exercises help some intermittent exotropias and convergence insufficiency - but they are not for every squint.

  • Botulinum toxin

    Chemodenervation of an overacting muscle - sometimes replaces surgery, sometimes prepares for it.

  • Standard recess-resect surgery

    The workhorse operation. Millimetric weakening of one muscle with strengthening of another.

  • Adjustable-suture surgery

    For adults, allowing next-day fine-tuning while awake.

  • Complex reoperation

    Revision after previous surgery, or with restrictive muscle disease, needs a subspecialist.

  • Watch-and-wait

    Some paralytic and post-viral squints recover over months. Waiting is a valid plan for six to twelve months.

Safety and recovery

What to expect afterwards - honestly.

A well-established procedure in the right hands. The honest conversation is about recovery and expectations.

  • The wrong operation is the biggest risk

    A squint operated at the wrong time or for the wrong angle produces overcorrection, undercorrection or diplopia. Careful assessment is the safeguard.

  • Overcorrection and undercorrection

    Around 10–25 percent of cases need a second smaller operation.

  • Double vision after adult surgery

    Adults may see double for days or weeks - most adapt. Persistent diplopia is uncommon with careful planning.

  • Amblyopia in children

    A lazy eye must be treated before surgery, or the surgery fails to give binocular vision.

  • Bleeding, infection, sclera perforation

    All uncommon. Antibiotic-steroid drops for 3–4 weeks minimise infection risk.

  • Anaesthetic risk

    General anaesthetic is standard. Fitness assessment for adults with comorbidity.

  • Follow-up matters

    Alignment can drift over years. Long-term orthoptic review is part of the deal.

  • Cosmetic outcome vs binocular vision

    Adults often want cosmetic alignment; children need functional binocular vision. Both are legitimate - but they change the plan.

  • Red flags after surgery

    Worsening pain, vision loss, sticky discharge or fever needs same-day contact.

Reading your notes

Your operation note in four parts. Read the last one first.

Whichever approach was used, the note the surgeon sends you keeps to the same shape.

A UK strabismus surgeon and orthoptist reviewing a patient’s notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note before your review, just ask.

  1. 01 Header

    Indication and approach

    Why the squint operation was done, which side, and what approach was chosen.

  2. 02 Technique

    What was done

    The technique in plain terms - incisions, structures addressed, implants or fixation used.

  3. 03 Findings

    Findings and complications

    What was seen and whether anything unexpected happened during the procedure.

  4. 04 Impression

    Plan, restrictions and follow-up

    Read this first: recovery restrictions, rehab timeline, and when we look at you again.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Usually covered when medically indicated.

Frequently asked

Everything we get asked about the decision.

Quick answers on cost, recovery and what happens if it does not work.

  • How is this page different from squint correction surgery?

    On our site, squint correction surgery focuses on the technique of the operation. This page - squint surgery - is the decision framework across children and adults: when to operate, when to try glasses, prisms or botulinum toxin, and when to wait. Both are performed by the same consultants.

  • When should a child have squint surgery?

    Congenital esotropia is usually operated between 12 and 24 months to protect binocular development. Acquired squints wait until any accommodative component has been fully treated with glasses. Amblyopia is corrected first.

  • Is it worth having squint surgery as an adult?

    Yes, in most cases. Adult squint surgery is a real functional and cosmetic operation, well supported by evidence for quality of life. It is not merely cosmetic and is often covered by private medical insurance where a functional element exists.

  • Will I lose vision from squint surgery?

    Extremely unlikely. Serious vision-threatening complications are under 1 in 1,000. Common short-term effects - a red eye, gritty feeling, mild diplopia - settle in weeks.

  • How much does private squint surgery cost in the UK?

    Roughly £4,500–£7,500 for two-muscle single-eye surgery, £5,500–£9,000 for bilateral, £5,500–£9,500 with adjustable sutures, and £6,000–£10,000 for revision. Botulinum toxin as an alternative is £950–£1,800.

  • Can I have squint surgery on the NHS?

    Yes, functional squint surgery is offered, but waits are typically 6–18 months. Purely cosmetic requests are variable and sometimes not funded. Private routes give quicker access and choice of surgeon.

Related treatments

Looking for something else?