Whether strabismus surgery is performed on one eye or both eyes at the same time depends on the degree of strabismus, the condition of the dominant eye, and the nature of the strabismus, such as concomitant strabismus, paralytic strabismus, etc. It needs to be decided whether one eye or both eyes should be operated on.

If the degree is quite severe, operating on the muscles of one eye may not resolve the issue, and it might be necessary to operate on the muscles of the other eye as well. However, a maximum of three rectus muscles can be operated on in one eye at the same time. Operating on more can lead to some complications. Therefore, whether to operate on one eye or both eyes should be determined based on the patient's actual condition.