Development of a low-cost strabismus surgery simulation model



Strabismus surgery training has historically focussed on the “see one, do one and teach one” approach. Simulation training offers an alternative to practice surgical skills without direct patient involvement. However, current simulation models for strabismus surgery are limited due to concerns regarding use of animal or human tissue and financial cost limiting practice. Our aim was to build and validate a low-cost model for obtaining the core skills required in strabismus surgery.


A low-cost strabismus model was developed using commercially available materials. Ophthalmic trainees, fellows and consultants were surveyed using a questionnaire to assess the realism and training utility of the model using a five-point Likert scale (1 = unacceptable, 2 = poor, 3 = acceptable, 4 = favourable and 5 = excellent) whilst simulating a horizontal muscle resection task.


Forty-two ophthalmologists completed the questionnaire. The model scored highly for muscle securing and suturing (median: 4.00) and suturing. Muscle dissection and conjunctiva were considered poor (median: 3.00, 2.50, respectively). Overall, participants felt that the model simulated strabismus surgery well (median: 4.00) and was comparable to other dry simulation models (median: 4.00).


Our study describes a favourable training model that can be used for independent practice of core strabismus surgical techniques. However, it remains a technical challenge to replicate certain ocular anatomy using commercially available materials.

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Fig. 1: Low-cost strabismus model.
Fig. 2: Face validity.
Fig. 3: Content validity.


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Malik, M., Shah, N., Kit, V. et al. Development of a low-cost strabismus surgery simulation model. Eye (2020).

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