title: Small Deviations: Vertical, Horizontal, and Combined.
abstract: OBJECTIVE
  Symptomatic, small-angle strabismus is largely an acquired problem of adults that has previously been managed with prism spectacles. This paper will explore surgical options that are becoming increasingly popular.
  
  
  METHODS
  The special issues that confound surgical treatment of small-angle strabismus are considered. Surgical procedures described in the literature and in the author's experience that address these issues are reviewed.
  
  
  RESULTS
  Several recently described surgical techniques show promise for treatment of small-angle strabismus in adults. Their use is illustrated in a case report. Review of the author's practice shows a rapid increase in surgery for small-angle strabismus.
  
  
  CONCLUSIONS
  Surgical strategies for small deviations are increasingly important to meet the spectacle-free expectations of our adult patients.
authors.affiliation: From the W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Archer
mesh_terms: D000368:Aged; D005133:Eye Movements / Q000502:physiology*; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D013285:Strabismus / Q000503:physiopathology / Q000601:surgery*
keywords: esotropia; small-angle strabismus; strabismus surgery; vertical strabismus