Patient: It was discovered in August this year that it was synoptic exotropia and single astigmatism, the doctor recommended to have surgery, but considering the small size of the child, general anesthesia was required. Currently, he is only prescribed glasses with 75 and 100 degrees of astigmatism and no myopia. I would like to know if surgery is necessary and what are the implications without surgery? Pang Lin, Strabismus and Pediatric Ophthalmology, Peking University First Hospital: If there is no combined amblyopia, it is not too early to operate now. If there is a big difference in vision between the two eyes with a mirror, the eye with good vision needs to be covered up so that the eye with poor vision (amblyopic eye) can improve its vision unexpectedly, otherwise the long-term effect of surgery will be reduced. External strabismus rarely heals on its own, it usually gets worse and worse, and long-term strabismus without treatment will affect the monocular function of both eyes and may form amblyopia.