Intermittent exotropic strabismus- BTDT?

[JTsMom]

Zachary was diagnosed with intermittent exotropic strabismus last year. We've been following up with his doctor every few months, and just watching it. At his last visit, she recommended patching one eye each day, but only if he would tolerate it, b/c she didn't think it would really help anyway. He wanted nothing to do with it, so I just dropped it.

Yesterday we went back, and although to me it looks like his eyes are wandering less frequently, she said she got the same results. Since he doesn't seem to be improving, she thinks he will need surgery, and recommended doing it sometime around the age of 4.

So I came home and Googled, and I'm seeing all kinds of conflicting information about how effective surgery is, vision therapy- the whole nine yards. I'd love to hear opinions from the wise moms here.

FWIW, Jason is also seen by doctors at the same practice for amblyopia. They recommended patching, and he has done really well with that. His vision is now excellent in both eyes, and we're done with treatment for now. I don't think they're quick to jump to surgery if it's not truly necessary, and they stressed there is no rush in Zach's case.

[Gena]

DS has intermittent exotropic strabismus in his left eye. He also had amplyopia in the same eye several years ago and patched for about a year. The patching fixed the amplyopia, but DS has some lingering strabismus. For DS, it''s part of this larger visual impairment. Because DS has albinism, his eyes have structural defects, including foveal hyperplasia and misrouted optic nerves. His eyes don't always work together well, so when he is intently focusing on something, he uses his right eye and the left wanders a little. (Recently I took him to his first 3D movie and I was thrilled to discover that his eyes do work together well enough to give him some depth perception!)

In DS's case, there isn't anything they can do to correct it, due to the structural issues. His isn't bad enough to make him a candidate for surgery. Even if he were, the surgery would only have a cosmetic effect and would not help his vision.

So that would be my main question in your shoes: would the surgery actually help his vision, or would it just stop the eye from wandering?

Hopefully others with experience with cases like Zach's will chime in.

[squimp]

I think I would want to get a second opinion if I didn't feel comfortable with the doctor's recommendation. I'm a little confused about the seemingly different treatment for the two conditions, but my DD doesn't have ambylopia.

DD has accommodative esotropia - her eye points in and she does it to focus (early reader). She has never been a candidate for surgery because her strabismus is corrected with glasses - the bifocals have kept her condition in check since she was diagnosed at 3 and she's 9 now. So her condition is a bit different. She sees the head of ped opth at our state's teaching university hospital, and I really trust his opinion.

[Cam&Clay]

DS1 has had surgery twice for exotropia. The first surgery did not fix it enough so there was a second surgery which overcorrected, resulting in esotropia. When they said it was time for surgery #3, I refused. We patched instead and he is fine now. Patching was hard but he got used to it.