Why do I need eye strabismus surgery for a squint? Most cases of strabismus are caused by abnormalities in the neck muscles and can often be treated with physical therapy or surgery, but some children have congenital oculomotor palsy. The vertical strabismus is caused by paralysis of the superior oblique muscle in one or both eyes, and the child uses a special head position such as deviated head and side face to compensate for the double vision. Long-term head tilt can have many negative consequences for the child. The facial asymmetry caused by head tilt (squint) can make one side of the face full and the other side thin. It can also affect the development of the spine, causing scoliosis of the cervical spine, etc. Therefore, the treatment of congenital oculomotor palsy caused by lordosis should be carried out early with ophthalmic surgery.