Is Surgery the right answer my 6 year old

My son is 6 years old. Until last summer (2009) he has had no vision problems. He passed his eye exams and had no problems with seeing anything from the smallest object to things very far away and he could see 3D at the movies. That summer we noticed that after he would swim for a long time he would squint one eye or the other and that hi eye would cross in. After swimming it would go away within a few hours or by the next morning. The ONLY time this would happen was when he would swim for long periods and only if he spent a lot of the time swimming under the water. We mentioned this his Pediatrician Dr. and they checked his vision again (it was great) and set up an appointment for him to see a eye Dr. We saw the Dr and he passed all his tests with flying colors. They said they had never heard of swimming causing crossed eyes. They set him up for another round of tests with his eyes dilated. He ended up having an allergic reaction to the med used to dilate his eyes (they never heard of that either) His vision dilated was very poor and they thought he might be near sighted but was just able to accommodate for it well enough to pass all his test. (I was not sure if they could really test his vision accurately after the reaction) They set up an appointment with him to see a specialist and we would go from there. At this point they had not seen him while his eyes were crossed. Before he could get into see the specialist he broke his leg and we canceled that appointment because of conflicts with Dr. schedules. Between getting him back on his feet and the fact that it was now winter and he was not swimming so we were not reminded about his eyes crossing we didn't get around to making a follow up appointment until Spring 2010. Again during all that time his eyes never crossed even when he was really tired and he had no problem sight. Sure enough though as soon as he started swimming it came back, only now it would start a lot sooner and would last longer. I took him swimming before his next appointment so they could see what we were talking about. They diagnosed him with accommodative esotropia. Although a lot of what they told me and what I later read online doesn't really fit what we have seen in my son. Again his eyes only crossed after swimming NEVER when he was just tired. He had NO problems with his sight. He was able to read without holding the book close to his face. THEY ONLY CROSSED AFTER SWIMMING. The Dr. said that while he had never heard of it presenting that way he was sure this was the issue with my son and that glasses should fix the problem. He felt that maybe I just hadn't noticed them crossing at other times (bull but what do I know I am only his Mom and spend the most time with him.) The Dr. said  that most likely this would just worst with out glass and that one day they would just stayed crossed. So we got a prescription. Through our insurance of course it takes weeks to get them in and of course since the Dr. said it would happen my sons eyes never uncrossed after that visit. This was June they crossed and stayed. First set of glass came in we tried them for a few weeks and my poor baby was miserable because not only was he now seeing double all the time but he couldn't see anything through the glasses from about 4 feet out. He was a trooper though and kept them on trying to make them work as we explained why he needed them. So next  appt. the Dr. tells me that he will give me the "benefit of the doubt" that my son had worn his glasses the whole time (I was p***** at that comment if you can't tell , I had just spent weeks watching him struggle with watching movies, seeing what was happening at the other end of table, when it would have been so easy to take them off and see just fine BUT HE DIDN'T) anyway so benefit of the doubt they test him with the glasses on and off and yes his vision is awful with them on so they give him a lower prescription hoping his eyes will accept them. He can see through them but they don't help with the crossing so they  next prescribed a 3rd set of lens stronger than the first. A few weeks of those and while they are not as bad as the 1st time his vision is still blurry from about 10 feet out. So they prescribed dilation drops (luckily he was not allergic to these) after dilation therapy his eyes accept these lens so he is back to seeing clear but still crossed and seeing double. So they start him on patching alternating eyes. He has been doing that for about seven weeks now. They say there is improvement but not enough (I keep saying they because he sees two different Dr.s in the same building for this) so now they want to do surgery on his eye. He says that things are closer to being one image but yes they are still double.   I know we need to fix the double vision what  I don't know is if surgery is really the right answer for him. I am still not sure about the diagnosis to begin with. My understanding of the surgery is that they will reposition the muscles in his eye to correct the crossing. When I asked if that would mean that he would not be seeing double any more after the surgery the answer is "Maybe". I am happy it was an honest answer but maybe is not good enough for my child. I also understand that once he has this surgery that the likelihood of him then having to have additional surgeries is very high.   I just feel like they went through this whole ordeal to "break" his eyes to see through the glasses and now a few months later we are exactly where we were in June only now he has to wear glasses. Now they want to try surgery and because I am not a Dr. and don't know enough about all the options exactly what caused this in the first place I feel kind of trapped by their options on this.  So that's why I am writing this to seek some other options. We have set an appointment with another Dr (2 hours away) for a second option as well but what do you all think. . .Is surgery really the best next step in this case. I don't want him to keep seeing double any longer than he has to and I don't him to have issues with depth and such but I also don't want him to have to deal with more surgeries in the future because of this one and what if they go in and do all this that is support to work and he still has the same issue or worse after?  He hasn't responded to any of the other treatments the way they thought he would so why do they think he will respond to the surgery correctly?  Thanks for any thoughts. .

[Ray T Oyakawa, MD]

I have no idea without examining your child.  You have not provided his refraction or the amount of esotropia.  Many patients require more than one surgery to fix a strabismus problem and some require multiple surgeries.

You might consider getting a referral to a University center.

Dr. O.