Improve eye alignment with adult strabismus care in Sydney

Discover how tailored treatment can help restore coordination between your eyes and support more comfortable, confident vision

Improve eye alignment with adult strabismus care in Sydney

Discover how tailored treatment can help restore coordination between your eyes and support more comfortable, confident vision

Over 20 years of eye care experience

Experts in cataract, refractive, and corneal treatments

Advanced diagnostic and surgical technology

Personalised care plans

With the right treatment, adult strabismus can be effectively managed

Learn how we assess eye alignment and explore treatment options to improve visual function, comfort, and confidence

Adult Strabismus and Double Vision

Adult strabismus occurs when the eyes are not aligned and do not work together.

As a result, patients may experience:

  • double vision (diplopia)
  • blurred or unstable vision
  • difficulty reading or driving
  • poor depth perception
  • eye strain or fatigue

In some cases, the brain suppresses one eye.

However, in many adults, double vision becomes the dominant symptom.

Although strabismus changes appearance, it is not primarily a cosmetic issue.

Instead, it is a disease of ocular alignment and binocular vision.

Importantly:

  • The brain detects facial asymmetry within milliseconds
  • Eye misalignment disrupts normal eye contact
  • This directly affects social perception

Because of this, patients are often judged unfairly.

However, the issue is not vanity. It is a recognised functional and psychosocial burden.

How the world perceives strabismus

Research shows that adults with strabismus are:

  • less likely to be offered jobs
  • less likely to be promoted
  • more likely to be judged negatively in social settings

In fact, studies have shown that strabismus can impact employability almost as much as other visible facial differences.

As a result, many patients adapt their behaviour:

  • avoiding eye contact
  • withdrawing socially
  • limiting professional opportunities

Therefore, Dr Shanel Sharma & the Team at Eye & Laser Surgeons, understand that we need to take this seriously and respectfully.

This is the part that is often missed.

Patients with adult strabismus frequently report:

  • self-consciousness
  • reduced confidence
  • social anxiety
  • difficulty forming relationships
  • frustration from double vision

Because of this, the condition affects both:

  • functional vision
  • psychological wellbeing

Importantly, these feelings are validated in multiple studies, including the AS-20 quality-of-life research.

Common symptoms include:

  • double vision
  • blurred vision
  • eye strain
  • headaches
  • difficulty focusing
  • an eye turning inward or outward

Adult strabismus can arise suddenly or gradually.

However, a key principle is this:

New strabismus must always be investigated if the diagnosis is not clear.

Below are common causes by pattern:

Common causes:

  • ESOTROPIA: Sixth nerve palsy, Childhood esotropia (decompensated), Consecutive esotropia (post-surgery)
  • EXOTROPIA: Decompensated childhood exotropia, Sensory exotropia (poor vision), Consecutive exotropia
  • HYPERTROPIA: Fourth nerve palsy, Thyroid eye disease, Trauma / restrictive causes.

In addition, systemic causes include:

  • diabetes and hypertension
  • multiple sclerosis
  • myasthenia gravis
  • intracranial pathology

This is why accurate diagnosis matters first

A proper assessment goes far beyond “which way the eye turns.”

Your assessment will include a combination of the following tests:

  • visual acuity and refraction
  • angle of deviation (distance and near)
  • eye movement patterns
  • binocular function and fusion
  • presence of double vision
  • variability of the deviation

In addition, further investigations may be required if a neurological cause is suspected.

Adult strabismus has a proven negative impact on quality of life.

It affects:

  • self-image
  • relationships
  • career progression
  • daily visual function

Dr Shanel Sharma co-authored a study on long-term botulinum toxin treatment showing that improving ocular alignment significantly improves patient quality of life.

Key findings include:

  • patients had significantly lower baseline quality-of-life scores
  • treatment improved both functional and psychosocial outcomes
  • many patients reported life-changing benefits

These findings align closely with real-world patient experiences seen in clinic.

Dr Shanel Sharma co-authored a British Journal of Ophthalmology paper on adults receiving long-term botulinum toxin A to maintain ocular alignment. That work adds to the evidence that the benefit of treatment should not be judged only by the angle of deviation on examination, but also by how the patient functions and feels in real life.

If treatment helps a patient work, read, drive, maintain eye contact, or stop hiding from photographs and social interaction, that is not trivial. That is a meaningful health outcome.

Take the first step toward clearer, healthier vision

Book an appointment to learn more about your eyes and the treatment options that may suit you

Take the first step toward clearer, healthier vision

Book an appointment to learn more about your eyes and the treatment options that may suit you

Hi, I’m Dr Daya Sharma

I’m a cataract, corneal and refractive surgeon with subspecialty training from Moorfields Eye Hospital in London and Sydney Eye Hospital. I perform laser vision correction procedures, refractive lens surgery, and advanced cataract surgery using the latest diagnostic and surgical technology. My work is focused on helping people reduce their dependence on glasses and improve their quality of vision at all distances. I’m actively involved in research, publication and surgical education, and I take pride in offering honest, thorough guidance to every patient. My approach is personal, careful and always tailored to individual needs and lifestyles.

Hi, I’m Dr Shanel Sharma

I’m an ophthalmologist with subspecialty training in paediatric eye conditions, strabismus, medical retina and general ophthalmology from leading hospitals in Sydney and London, including Moorfields Eye Hospital. I hold a Fellowship with RANZCO and have published widely in peer-reviewed journals. My focus is providing careful, individualised care using evidence-based treatments. I’m accredited to treat a range of conditions and perform procedures including intravitreal injections, strabismus surgery and botulinum toxin treatments. I always aim to make the process clear, calm and supportive.