The average cost of strabismus surgery is $6,700, but out-of-pocket costs can range from $4,000 (with insurance) to as much as $9,000, according to RealSelf member reviews.
Read on to find out why you might pay more or less for strabismus surgery (aka eye muscle surgery or crossed eye surgery) and whether patients say the cost is worth it.
Related: Everything You Need to Know About Strabismus Surgery
Most insurance companies cover this surgical procedure because it corrects a medical condition that causes functional disability. For instance, misaligned eyes can cause blurry vision, double vision, poor depth perception, lazy eye (amblyopia), eye fatigue, and headaches.
Some insurance policies have restrictions—for instance, on who may perform your surgery and what will be covered—and other limitations. So it's smart to start by checking with your insurance company yourself, to find out if you need to choose an in-network provider or anticipate out-of-pocket costs.
For instance, a steroid and/or antibiotic eye drop will be applied to the eye post-surgery, so you may need to cover a copay for the prescription.
Other eye problems associated with strabismus (including amblyopia, eyelid ptosis, and cataracts) are usually treated prior to eye muscle surgery. These procedures may also be covered by insurance, but they may come with additional out-of-pocket expenses.
Typically, your eye doctor's staff will also verify your coverage (including copayments and deductibles) with your insurance provider prior to your surgery.
Adult strabismus surgery does not change corrective lens prescriptions to any appreciable degree, so you shouldn't have the expense of new glasses or contact lenses after surgery.
Whether or not you have insurance that will cover a portion of the cost is the biggest factor in how much you'll pay for this surgical treatment.
If you have to pay entirely out of pocket, these factors will also impact your final bill.
Eye misalignment can be diagnosed by a host of medical specialists (including pediatricians, optometrists, and general practitioners). But strabismus surgery is a delicate procedure that should be performed by a specialist in eye alignment surgery, usually an ophthalmologist or oculoplastic surgeon.
Surgeons with more specialized training and experience often charge a higher surgeon's fee.
Don't be surprised if the specialist you end up seeing is a pediatric ophthalmologist. Misaligned eyes are more common in children, so providers who care for children tend to have the most expertise in treating strabismus.
However, providers who are trained to perform strabismus surgery should be trained to perform it on patients of all ages.
If you have to travel to be treated by a qualified surgeon, this will involve extra out-of-pocket costs, like transportation and accommodations.
Strabismus can be mild, but more severe cases can require more than one procedure to provide full correction—so the eyes move and work better together (aka binocular vision).
Since the condition usually develops in infants and young children, and it will get worse if left untreated, it's usually treated within a few years of it being diagnosed, during a pediatric eye exam.
Most adults with strabismus have had it since they were children, though it can start—or becomes suddenly noticeable, as it recurs or progresses—later in life.
Each operation has a 60%–80% chance of successful correction, according to one recent study.
Even once it's successful, you may still need to wear eyeglasses or contact lenses.
Strabismus surgery is usually performed in a hospital or surgery center as an outpatient procedure. This means you won't incur the expense of staying overnight in the facility. Outpatient surgery also provides significant savings, with costs running up to more than 50 percent less than hospitals.
Most children undergo the procedure under general anesthesia (so they're fully asleep), but local anesthesia with conscious sedation is the standard for adults.
It can also be less expensive, depending on whether it's administered by an anesthesiologist or nurse anesthetist.
One surprising cost factor is the suturing technique used by your provider.
Strabismus surgery involves altering the position and/or the length of the eye muscle, to correct excess muscle strength or weakness, and sewing the muscle to the wall of the eye.
Standard strabismus surgery techniques involve tying a permanent knot.
However, the adjustable suture technique uses a temporary knot in an accessible position. After surgery, your eye doctor evaluates the patient's ocular alignment, using the suture to tighten or loosen the treated muscle. Once the desired alignment is achieved, the surgeon ties the suture permanently in place.
The adjustable suture technique is performed on patients who are awake (the eye is numbed with anesthetic) and able to cooperate with the adjustment process. Since it requires more time both in the operating room and postoperatively, it's typically more expensive. But the results can be superior.
Surgical procedures usually cost more in major metro areas, which have a higher cost of living. (Surgeons have to pay rent, too.)
That said, larger metro areas usually have a large number of qualified providers, and some may offer competitive pricing to draw in more patients.
If you're willing to drive a bit further (or even travel outside your area), it can be worth your time to get price quotes from experienced surgeons in a few different areas. Just be sure to ask what the price they quote you includes, so you won't be surprised by additional fees when the bill arrives.
For most patients, adult strabismus surgery is a successful, safe, and effective treatment. One study found a significant improvement in the quality of life after the surgery.
Surgery is the longest-lasting (and, in the long run, the most cost-effective) treatment for strabismus, Botox injections may be another treatment option in certain instances.
Botox was first developed to treat crossed eyes, and it's FDA approved for this medical indication, so many insurance plans cover this treatment.
Diluted amounts of the toxin are injected into specific eye muscles to weaken them. As the muscles relax, the eyes become more aligned, leading to better vision.
Similar to its cosmetic effects, the effects of Botox on the eye muscles typically last around 3–4 months and need to be repeated to maintain the result.
A board-certified ophthalmologist or ocuoplastic surgeon who specializes in strabismus treatment can evaluate your situation and determine whether you're a good candidate for either of these procedures.