Reasons for delay of surgical intervention in adult strabismus

Background: it has been our impression that adult patients with strabismus frequently delay surgical intervention. Objectives: To determine the length of time adult patients waited before undergoing strabismus surgery and to determine the reasons why these delays occurred. Design, Setting, and Participants: Prospective survey of consecutive patients who delayed strabismus surgery for more than 1 year. Intervention: Preoperative survey. Main Outcome Measures: The primary outcome measure was time between the onset of strabismus and surgery and the reason why surgery had not been previously sought. Results: The mean age among 128 study participants was 45.7 years (age range, 18-86 years). The mean time between the onset of current strabismus and surgery was 19.9 years (range, 1-72 years). The major reasons for delay in seeking surgical treatment included the following: surgery was never offered by eye care specialist (35 patients [27%]), surgery was offered but declined by the patient (29 patients [23%]), the patient had received prior satisfactory nonsurgical care (17 patients [13%]), the patient had never sought care (14 patients [11%]), the patient had a previous poor surgical experience (8 patients [6%]), and the patient had been told by their eye specialist that nothing could be done or that surgery could make them worse (8 patients [6%]). Conclusions: Strabismus surgery is often delayed for many years in adult patients who could potentially benefit from it. Almost half of such delays could be avoided by better education of the lay public and the medical community.