Strabismus surgery is divided into local anesthesia and general anesthesia. Local anesthesia is a local anesthetic given while the patient is awake, while general anesthesia is an inhalation anesthetic, and the child “sleeps” after the surgery. After general anesthesia, the eye position cannot be adjusted intraoperatively, so the amount of surgery can only be designed according to the preoperative measurement of strabismus and according to the laws of the general population. For example, it is like taking medicine after a cold, the average person can get well with two pills, but there are always individual differences, some people may not have enough pills and some may have too much. Therefore, in order to increase the accuracy of the surgery, it is best if the patient can receive local anesthesia. On the other hand, strabismus needs to be operated as early as possible to facilitate the development and establishment of binocular vision and stereopsis. In clinical practice, there are often children of 7-12 years of age who need strabismus correction surgery, so can these young patients undergo local anesthesia? The answer is yes, as long as the conditions are present. To undergo local anesthesia surgery, two conditions need to be present: first, the patient knows that he or she is going to undergo the surgery and agrees to local anesthesia; and second, to ensure that the procedure is painless. In fact, our team has improved the anesthesia method of local anesthesia (the article was accepted by the Chinese Journal of Ophthalmology) and the surgical operation method to avoid intraoperative discomfort. In a large number of young patients we treat, local anesthesia can be used as long as the child is willing and not afraid. For example, the following two young patients were operated under local anesthesia for bilateral exotropia correction. The picture on the left shows a 5.5-year-old patient sitting up to observe the eye position during surgery, and the picture on the right shows a 6-year-old patient checking the eye position during surgery. Although local anesthesia can be performed successfully in younger patients, it should be noted that the decision to operate under local anesthesia is made by the operator after evaluating the young patient. For some special types of strabismus, we still use general anesthesia as a rule. In fact, the current pediatric general anesthesia has developed rapidly, including anesthesia machines, inhalation gases, drugs and materials used, and anesthesia methods have been fully in line with international standards, and are also extremely safe.