Which should be treated first, amblyopia or strabismus?

  The treatment principles for amblyopia combined with strabismus are complex and should be developed on a case-by-case basis. The following are the treatment principles we have developed over the years: (1) Intermittent exotropia: If the child has balanced visual acuity in both eyes after amblyopia training, and at the same time the examination reveals that the visual function of both eyes is gradually deteriorating, you can consider strabismus surgery first, followed by amblyopia training.  (2) Partially adjusted internal strabismus: After the visual acuity of both eyes is balanced, the child should be operated as early as possible in the presence of tertiary visual function, and then amblyopia treatment should be performed after the surgery and re-fitting with appropriate glasses.  (3) Constant exotropia: Amblyopia treatment can be considered first, and then strabismus surgery can be performed after the visual acuity has reached normal.  (4) Constant internal strabismus: amblyopia treatment can be considered first, and strabismus surgery can be performed after the visual acuity has reached normal.  (5) Paralytic strabismus: If there is a compensated head position, in order to correct the abnormal development of bones, teeth and neck muscles brought about by the compensated head position as soon as possible, surgery can be considered first, and amblyopia treatment can be performed after the surgery.  (6) For special types of strabismus such as DVD, different treatment principles are formulated according to different conditions.  Why should strabismus surgery not be performed first and then amblyopia treatment?  Some hospitals often give children strabismus treatment first and then instruct them to perform amblyopia training, which is just not right, because the degree of amblyopia is different for children with strabismus, and of course there are refractive parallax and monocular severe amblyopia, if the arrangement is not reasonable, children who have strabismus surgery need amblyopia training, and if they need monocular masking, after masking monocular, it will often break the binocular vision of the child after strabismus correction, i.e., disrupt the fusion, which increases the chance of fusion. balance, that is, disrupting the fusion, increasing the basis for the occurrence of new strabismus, and over time it is easy to form new strabismus, and children with exotropia are prone to recurrence of strabismus after surgery, and children with internal strabismus are prone to exotropia after surgery.