Adult Squint Explained: Symptoms, Causes and Treatment Options
Why Choose Private Squint Surgery?
In the UK, squint surgery may be performed via the NHS, through insurance, or as self-pay. NHS treatment is free, but waiting times can be long and surgery is often performed by trainees under supervision. Many operations are carried out by surgeons who mainly specialise in children’s squint rather than adult complex cases.
With insurance, fees are standardised — meaning some leading specialists choose not to participate. Self-pay allows you to choose your surgeon directly and prioritise experience, specialisation, and access.
Many centres quote only a surgical fee. Hospital costs, anaesthetic fees and follow-ups are frequently additional. At London Squint Clinic, everything is included in one transparent package.
Our Complete Package – £10,000
- ✔ Advanced surgery by Mr Ali (one or both eyes)
- ✔ Adjustable sutures where clinically indicated
- ✔ Detailed orthoptic planning
- ✔ All hospital & anaesthetic fees included
- ✔ Post-operative medication
- ✔ Two video follow-ups
- ✔ Face-to-face review appointment
What Makes Us Different
- ✔ 100% focused on adult squint & double vision surgery
- ✔ >95% audited success rate
- ✔ Free re-treatment at 3 months if worse (extremely rare)
- ✔ 24/7 direct WhatsApp access to your surgeon during recovery
- ✔ Optional well-being session & pre-op reassurance call
Initial consultation: from £150
Surgery typically within 4 weeks. No referral required. Self-pay only.
Adult Squint Explained: Your Path to Clear Vision
This guide provides a comprehensive overview of Adult Squint Explained: Symptoms, Causes and Treatment Options. We detail our unique patient journey from consultation to recovery, our transparent, all-inclusive pricing packages, and the advanced adjustable suture techniques that set us apart. You will gain a clear understanding of your options at the UK’s only clinic with a 100% focus on adult squint, backed by our dedicated 24/7 post-operative support.
Your care is led by Mr Nadeem Ali, a Cambridge Triple First graduate and former Consultant at Moorfields Eye Hospital. As the UK’s only centre 100% dedicated to adult squint and double vision, our exclusive specialisation underpins an audited 95% surgical success rate. This singular focus ensures you receive world-class, evidence-based treatment from a leading expert in the field, providing ultimate reassurance and premium results.
To receive a world-class assessment and tailored surgical plan, book your consultation at the London Squint Clinic today. No GP referral is required.
Table of Contents
- What Is Adult Squint (Strabismus)?
- What Causes Eye Misalignment and Double Vision in Adults?
- What Are My Treatment Options for Adult Strabismus?
- The London Squint Clinic Surgical Procedure: What to Expect
- Your Recovery Timeline with Our 24/7 Surgical Support
- Our Transparent Surgical Package Cost
- Why Choose Mr Ali at The London Squint Clinic?
- Book Your Expert Consultation Today
What Is Adult Squint (Strabismus)?
Adult squint, or strabismus, is a condition where the eyes are misaligned and do not point in the same direction. This misalignment prevents the eyes from working together, often leading to disruptive symptoms like double vision (diplopia), eye strain, and headaches, significantly impacting daily activities like driving and reading.
While commonly associated with childhood, strabismus can develop at any age or be a recurrence of a childhood condition. The brain can no longer ignore the image from the misaligned eye, causing the two separate images to be perceived simultaneously. This condition is more than a cosmetic concern; it is a functional and neurological issue that disrupts binocular vision. Fortunately, effective treatments are available. For many, modern squint surgery offers a highly successful and permanent solution, realigning the eyes to restore single, comfortable vision and improve quality of life. This guide, “Adult Squint Explained: Symptoms, Causes and Treatment Options”, will provide a comprehensive overview. Understanding strabismus in adults explained clearly is the first step towards seeking a definitive and reassuring solution with a dedicated specialist like Mr Nadeem Ali.
What Causes Eye Misalignment and Double Vision in Adults?
Understanding the root of adult squint is crucial for effective treatment. Unlike childhood strabismus, where the brain often learns to suppress an eye, adult-onset misalignment typically causes immediate and distressing double vision. The causes are varied, ranging from decompensation of a pre-existing condition to new neurological or muscular issues. An expert diagnosis from a specialist is essential to pinpoint the exact cause and formulate the most effective treatment plan.
Common causes and squint signs in adults include:
- Decompensated Childhood Squint: Many adults had a mild, well-controlled squint in childhood that the brain could manage. With age, illness, or stress, the brain’s control can weaken, causing the misalignment and double vision to become apparent.
- Neurological Conditions: Conditions affecting the cranial nerves that control eye muscles can lead to strabismus. This can include stroke, head injury, brain tumours, or conditions like multiple sclerosis. The sudden onset of double vision always warrants a thorough investigation.
- Thyroid Eye Disease: This autoimmune condition causes inflammation and swelling of the tissues and muscles around the eyes, restricting movement and leading to misalignment and double vision.
- Previous Eye Surgery: Complications from other eye surgeries, such as cataract or retinal detachment surgery, can sometimes damage the delicate eye muscles, resulting in strabismus.
- Idiopathic Causes: In some cases, a specific cause cannot be identified. This is often referred to as late-onset strabismus or a microvascular issue where a tiny blood vessel supplying an eye movement nerve becomes blocked, often resolving spontaneously over several months but sometimes requiring treatment if it persists.
A comprehensive assessment of your “adult squint symptoms causes treatment” profile at The London Squint Clinic ensures that we not only address the misalignment but also understand its underlying origin, providing you with the most appropriate and evidence-based care.
What Are My Treatment Options for Adult Strabismus?
Once a thorough diagnosis is complete, a personalised treatment plan is developed. At The London Squint Clinic, we believe in an evidence-based approach, exploring all viable options to find the one that best suits your clinical needs and lifestyle. While surgery is often the definitive solution, several non-surgical methods can be effective for managing symptoms, particularly for smaller or intermittent squints. These adult eye misalignment treatment options range from simple observation to advanced surgical techniques.
Here is a comparison of the primary treatment pathways for adult strabismus:
| Treatment Type | Description | Best Suited For |
|---|---|---|
| Prisms | Special lenses incorporated into glasses that bend light to help align the images from both eyes, relieving double vision. | Small, stable squints. They are often a good temporary measure or an alternative for those who are not surgical candidates. |
| Botulinum Toxin (Botox®) | Injected into an eye muscle to temporarily weaken it, allowing the opposing muscle to pull the eye into a better position. The effect lasts for a few months. | Specific types of strabismus, such as nerve palsies, or as a diagnostic tool to predict surgical outcomes. |
| Squint Surgery | A highly precise procedure to physically adjust the tension of the eye muscles, repositioning the eye to achieve proper alignment. This is the most effective and permanent solution. | Most cases of moderate to large squints, or when non-surgical options have failed to provide satisfactory relief. It is the definitive treatment for restoring binocular vision. |
The decision on the best course of action is made collaboratively during your consultation. Mr Nadeem Ali will explain the “adult squint symptoms causes treatment” pathway in detail, discussing the pros and cons of each option. While prisms can offer relief, they do not correct the underlying misalignment. Surgery, especially with modern techniques like adjustable sutures performed by a specialist, offers the highest success rate—an audited 95% at our clinic—for a permanent and cosmetically superior result.
The London Squint Clinic Surgical Procedure: What to Expect
Embarking on squint surgery is a significant step, and at The London Squint Clinic, we ensure your journey is seamless, reassuring, and meticulously planned. Unlike general ophthalmology clinics where squint surgery might be one of many procedures offered, Mr Nadeem Ali dedicates 100% of his private practice exclusively to adult squint and double vision. This singular focus is exceptionally rare and is the cornerstone of our audited 95% success rate. You are not just another patient; you are receiving care from a surgeon whose entire professional focus is dedicated to mastering this one highly specialised field.
Our surgical process is designed for precision, safety, and optimal outcomes, incorporating Mr Ali’s expertise in adjustable suture techniques. This advanced method allows for fine-tuning of the eye’s alignment in the hours after surgery, while you are awake, ensuring the highest possible degree of accuracy.
| Stage | What Happens | Key Benefit |
|---|---|---|
| 1. Pre-Operative Assessment | A comprehensive consultation with Mr Ali, including detailed measurements and a discussion of your surgical plan. All questions are answered to ensure you feel fully informed and confident. | A bespoke surgical plan is created, tailored precisely to your unique eye alignment and medical history. |
| 2. The Day of Surgery | The procedure is performed as day-case surgery under general anaesthetic. Mr Ali carefully repositions the eye muscles and uses adjustable sutures, which are left accessible for later refinement. | The procedure is comfortable and efficient, typically lasting less than an hour. The use of adjustable sutures sets the stage for unparalleled precision. |
| 3. Post-Operative Adjustment | A few hours after you have woken up, Mr Ali assesses your eye alignment. If a micro-adjustment is needed, he can gently tighten or loosen the sutures in a simple, painless process to achieve perfect alignment. | This is the key to our 95% success rate. It allows for real-time correction that standard surgery cannot offer, maximizing the chance of a perfect outcome in a single operation. |
| 4. Finalisation | Once the alignment is perfect, the sutures are secured with a drop of anaesthetic, and you are ready to go home the same day. | You leave the clinic with the confidence that your eye alignment has been optimised to the highest possible standard. |
Your Recovery Timeline with Our 24/7 Surgical Support
A successful outcome depends not only on surgical excellence but also on a smooth and well-supported recovery. At The London Squint Clinic, we provide a comprehensive aftercare programme to ensure you feel secure and informed every step of the way. Your eye will feel gritty and appear red immediately after surgery, which is completely normal. The redness can take 6-8 weeks to fully resolve, but the discomfort typically subsides within the first week. We provide a clear schedule for eye drops to prevent infection and reduce inflammation.
Most patients can return to non-strenuous work and normal daily activities within one to two weeks. We advise avoiding swimming and heavy lifting for approximately four weeks to allow the eye muscles to heal properly. Driving can usually be resumed once you are free from double vision and feel confident in your visual acuity, typically within a few days to a week. Your vision will continue to stabilise over the following weeks as your brain adapts to the new eye alignment.
A key component of our premium service is our commitment to your peace of mind. All surgical package patients are given direct WhatsApp access to our clinical team for any concerns that may arise during the recovery period. This 24/7 surgical support ensures that a simple question or a worry can be addressed promptly by the people who know your case best, avoiding unnecessary anxiety. Your follow-up care includes two scheduled video consultations and a final face-to-face review with Mr Ali to monitor your progress and ensure a perfect long-term result.
Our Transparent Surgical Package Cost
We believe that clarity and trust are paramount, especially when it comes to the cost of your care. The London Squint Clinic operates with a policy of complete transparency, ensuring you have a full understanding of the investment in your vision from the very beginning. There are no hidden fees or unexpected charges. Your journey begins with an initial consultation with Mr Nadeem Ali for a fixed fee from £150, where your condition will be expertly assessed.
Should you be a candidate for surgery and wish to proceed, our all-inclusive surgical package is £12,000. This single, comprehensive fee covers every aspect of your world-class treatment and aftercare. We position this as a premium investment in a life-changing procedure, performed by one of the world’s leading specialists in the field. The value is in the expertise, the dedicated focus, and the complete peace of mind provided by our wrap-around service.
Our commitment is to provide transparent, no hidden costs care. The package includes:
| Service | Included in £12,000 Package |
|---|---|
| Initial Consultation Fee | Deducted from the final package price |
| All Surgical & Hospital Fees | Includes surgery on one or both eyes as required |
| Anaesthetist’s Fees | Covered in full |
| Advanced Adjustable Sutures | Included as standard for maximum precision |
| Post-Operative Medications | All necessary eye drops are provided |
| Comprehensive Follow-Up Care | 2 video reviews and 1 face-to-face consultation with Mr Ali |
| 24/7 Post-Operative Support | Direct WhatsApp access to our clinical team during recovery |
| Re-treatment Guarantee | Free re-treatment at 3 months if the outcome is worse (extremely rare) |
Why Choose Mr Ali at The London Squint Clinic?
Choosing a surgeon is the most critical decision you will make in your treatment journey. Your vision and quality of life are at stake, and the choice demands a specialist with unparalleled expertise, a proven track record, and an unwavering dedication to their field. Mr Nadeem Ali represents the pinnacle of this specialisation, offering a level of focus and experience that is virtually unmatched in the UK and globally.
Mr Ali’s credentials provide a foundation of academic and clinical excellence. He graduated from the University of Cambridge with Triple First Class Honours degrees (MA MB BChir), a testament to his intellectual rigour. His surgical training culminated in his appointment as a Consultant Ophthalmic Surgeon at the world-renowned Moorfields Eye Hospital, where he served for 13 years, honing his skills at one of the globe’s foremost eye institutions. His dedication to safety and excellence is underscored by his published safety audit of over 4,000 squint surgeries—one of the largest series in the world—reassuring you that you are in the safest possible hands.
After a distinguished career in the NHS, Mr Ali made the deliberate choice to dedicate 100% of his private practice to adult squint and double vision. This is not a procedure he performs “on the side”; it is his sole professional passion. With over 24 years of experience, he has a deep, nuanced understanding of every facet of the condition. This exclusive focus allows him to deliver the highly audited 95% success rate that gives his patients profound confidence. By choosing The London Squint Clinic, you are not just choosing a surgeon; you are choosing a world-leading expert who has dedicated his entire career to perfecting the art and science of adult strabismus surgery.
Book Your Expert Consultation Today
Living with a squint or double vision can be isolating and frustrating, but a clear, effective, and permanent solution is within reach. Taking the first step towards treatment can feel daunting, but at The London Squint Clinic, we make the process straightforward, transparent, and reassuring. An expert consultation with Mr Nadeem Ali is your opportunity to have your condition thoroughly assessed, understand the underlying causes, and receive a clear, evidence-based plan for restoring your vision and confidence.
There is no need to wait for a GP referral. You can book your appointment directly with our clinic and typically be seen within a week. This initial £150 consultation is a comprehensive diagnostic session where you can ask every question you have and gain the clarity needed to make an informed decision. Let us help you put the challenges of strabismus behind you and look forward to a future of clear, comfortable, single vision.
To take the first step towards correcting your eye alignment or double vision, book your £150 initial consultation with Mr Nadeem Ali. With no referral required, you can secure an appointment within one week. For quick enquiries, message our team directly on WhatsApp.
Your Adult Squint Questions Answered
What are the most common symptoms of a squint in adults?
The most prominent symptoms of adult squint, or strabismus, are visibly misaligned eyes and double vision (diplopia). Adults may also experience eye strain, fatigue, headaches, difficulty focusing, or a pulling sensation around the eyes. Some individuals subconsciously close or cover one eye to alleviate the symptoms.
These symptoms can develop gradually over time or appear very suddenly. A comprehensive diagnostic consultation with a specialist is essential to determine the underlying cause and the most effective treatment pathway for your specific condition.
How is adult squint diagnosed?
Adult squint is diagnosed during a specialist consultation that includes a detailed review of your medical history and a series of orthoptic eye tests. Mr Ali will assess your eye alignment, muscle function, and binocular vision (how your eyes work together) using advanced diagnostic equipment to precisely measure the deviation.
This thorough, evidence-based assessment is crucial for creating a bespoke treatment plan, whether it involves non-surgical management or a highly tailored surgical procedure to restore alignment and single vision.
Can adult squint be treated without surgery?
Yes, in some cases, adult squint can be managed effectively without surgery. Non-surgical options include specialised prism glasses to correct double vision, eye exercises (orthoptics) to improve muscle control, or botulinum toxin injections to temporarily relax certain eye muscles and improve alignment for smaller squints.
While these methods can be effective, surgery often provides a more permanent and successful outcome for moderate to large squints. Mr Ali will provide an expert, evidence-based recommendation on the optimal treatment for your individual circumstances.
What are adjustable sutures and why are they recommended?
Adjustable sutures are an advanced surgical technique where the eye muscles are reattached with a temporary, adjustable knot. This allows for fine-tuning of the eye’s alignment in the hours after the operation, while you are awake and comfortable, to achieve the most precise and successful outcome possible.
Mr Ali’s exclusive focus on adult squint surgery includes extensive expertise in this technique, which significantly contributes to our 95% audited success rate. It offers an unparalleled level of precision not typically available in standard squint procedures.
Is adult squint surgery painful?
Adult squint surgery is performed under anaesthesia, so you will not feel any pain during the procedure. Post-operatively, it is normal to experience some discomfort, grittiness, or aching, which is very effectively managed with prescribed anti-inflammatory eye drops and standard oral painkillers like paracetamol or ibuprofen.
Most patients report that the discomfort is mild and subsides significantly within the first few days. Our dedicated 24/7 post-operative support is always available to provide reassurance and address any concerns you may have during your recovery.
What happens during my initial consultation with Mr Ali?
Your initial 45-minute consultation is a comprehensive assessment where Mr Ali will personally discuss your symptoms, conduct detailed diagnostic tests to measure your eye alignment, and explain the cause of your squint. He will then present all viable treatment options and collaboratively formulate a personalised management plan with you.
This is a dedicated, unhurried appointment designed to provide you with a clear diagnosis, a full understanding of your condition, and the confidence to make an informed decision about your care pathway.
Find out if you are suitable for Double Vision Treatment
Find out if you could benefit from this life changing surgery by contacting us today
Our most popular procedures

Hello, I’m Nadeem Ali
I’m one of the few eye surgeons in the world with 100% focus on Squint and Double Vision Surgery.
I have 24 years of eye surgery experience, and worked for 13 years as a Consultant at London’s renowned Moorfields Eye Hospital.
In 2023, I left the NHS to focus fully on treating patients from across the world at the London Squint Clinic. You can read more about me here.
There’s lots of information on the website about: squint surgery, double vision surgery and our pricing.
The most rewarding part of my job is hearing patients tell me how squint or double vision surgery has changed their lives. You can hear these stories here.
Mr Nadeem Ali
MA MB BChir MRCOphth FRCSEd(Ophth)

