An increasing number of people undergo refractive surgery, and even if the refractive result after surgery is perfect, the outcome is not always successful. Decompensation of binocular vision anomalies is rarely mentioned in reports considering the outcome of refractive surgery. This report presents 4 cases with binocular vision problems after refractive laser surgery. The patients were referred to the eye department of a Norwegian hospital after having received refractive laser surgery. All patients were male adults. For all patients the reason for referral was intermittent or constant binocular diplopia. Examinations were performed according to standard procedures of the hospital eye department. Two patients were diagnosed with decompensated esodeviations; they both had a history of treatment for accommodative esotropia. One patient had unstable binocular vision of unknown cause, and one had a decompensated congenital trochlear nerve paresis. Some binocular vision problems can be foreseen with proper evaluation before surgery. A thorough history and binocular evaluation are recommended before initiating refractive laser surgery.

An increasing number of people undergo refractive surgery, and even if the refractive result after surgery is perfect, the outcome is not always successful. Decompensation of binocular vision anomalies is rarely mentioned in reports considering the outcome of refractive surgery. This report presents 4 cases with binocular vision problems after refractive laser surgery. The patients were referred to the eye department of a Norwegian hospital after having received refractive laser surgery. All patients were male adults. For all patients the reason for referral was intermittent or constant binocular diplopia. Examinations were performed according to standard procedures of the hospital eye department. Two patients were diagnosed with decompensated esodeviations; they both had a history of treatment for accommodative esotropia. One patient had unstable binocular vision of unknown cause, and one had a decompensated congenital trochlear nerve paresis. Some binocular vision problems can be foreseen with proper evaluation before surgery. A thorough history and binocular evaluation are recommended before initiating refractive laser surgery.