strabismus with macular pucker

[casey59]

I have macular pucker in my left eye, it has gotten worse in the last year, I now have strabismus also in that eye now, is it possibly due to my vision being weakened and distorted in that eye that has caused the muscle weaknessand my good right eye having to do a lot of the focusing, I have noticed a lot of eye strain for the past year but thought it was due to the macular pucker , I just found out about the strabismus after a visit to my optometrist.  I had planned to have ERM peel this summer, will the peel help correct the strabismus or will I have to have surgery for the strabismus first?I do not have double vision,just eye strain.

[JodieJ]

As I stated on another thread, it is possible under certain circumstances for the distortion (but not reduced acuity) related to a macular pucker to cause small angle strabismus (Benegas NM et al, Diplopia secondary to aniseikonia associated with macular disease, Arch. Ophthalmol., 1999).  However, I don't think that any ophthalmologist can answer your questions about your own condition without examining your eyes and knowing more about your history.  If you haven't already done so, you should consult a strabismus specialist.

[casey59]

I was wondering if the strabismus in my left eye developed as a result of the macular pucker that was in the left eye. I wondered if the muscles in the left eye became imbalanced due to the fact that the vision in my left eye was reduced and my right eye was doing most of the focusing, or did the strabismus just develop independently of the pucker?  Thank you for the info.

[John C Hagan III, MD, FACS, FAAO]

No ERM peel will likely not help strabismus. If you have strabismis surgery it should be after peel. Note strabismus surgery in adult with reduced or poor vision in one eye has low success rate.

JCH MD