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Hello, Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .
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Since how long have you had the heterophoria? What is the vision in each eye?
About 4 years. OD: -3.50, OS: -4.00
Ok. What is the vision in each eye after correction? Is it 20/20?
Have you been suggested surgery by your ophthalmologist?
Invariably exophoria for near is due to convergence insufficiency. This improves in most individuals with eye muscle exercises alone. Since the vision in each eye is 20/20 with correction, it shows that there is no amblyopia . Thus surgery may not be required.
I've done a program of eye exercises for 20 weeks and it has not helped much. Is surgery an option at all?
I would give the eye exercises more time and advise its continuation. Though surgery is mentioned as the last resort when all orthoptic exercises have failed, it would require to be done in both eyes ( bilateral medial rectus resection). This surgery itself may induce some amount of double vision or even can have recurrance of convergence insufficiency.
I see. What is the chance of success (no complications) of such a surgery?
That would be very difficult to comment upon as it would depend on the surgical expertise of the specialist. It is to be kept in mind that over correction or under correction are more common than a precise correction. Pediatric ophthalmologist and squint specialists are the right experts in this field and should be consulted upon for an exact evaluation.
I see. How about Botox? Do you think it could be an effective treatment in this case?
No, I would certainly never recommend it.
Is there anything else that I can answer for you?
One more question, please. I notice that when I move my eyes between two different points in space, the world itself seems to shift. I think this might be connected to the fact that when I took the cheiroscope test in the vision therapy office, the shape I was trying to draw kept moving around when I traced it with my eyes. Is this due to the heterophoria, a different problem, or is it normal?
It is likely that the problem is due to the heterophoria itself.
I see. Thanks for your help today.