Whether 45-year-old strabismus needs surgical treatment needs to be judged according to the patient’s strabismus etiology, type and severity. If paralytic strabismus caused by congenital developmental abnormalities, sinusitis and sinus surgery, head trauma and other factors, the patient needs to treat the cause of the original disease, when the degree of strabismus is not more than 10 degrees, there is no double vision, does not affect the normal life, you can not do the surgery, can be treated by prism glasses. If the patient’s strabismus is large, then surgical treatment is needed. If the patient suffers from accommodative strabismus, which is mainly caused by refractive error, the patient can wear glasses to correct the refractive error, so as to balance the eye position, and does not need to perform surgical treatment. It is recommended that patients with strabismus should consult a doctor in time to evaluate their condition and follow the doctor’s instructions.