For this study the authors reviewed patients with bilaterally poor vision undergoing surgery for ocular realignment. Their vision was sufficiently low that patients could not assess their appearance. The purpose of the study was to document patient satisfaction with strabismus surgery in this cohort of 17 patients. Their mean age was 36 years (19-44); 13 exotropia patients had a mean angle of 52PD (20-90) and four esotropic patients had a mean angle of 54PD (30-70). No patient had diplopia. The patients were aware of perceptions of others regarding their ocular alignment and this influenced their feelings about themselves and their quality of life. All were happy with the postoperative outcome with improvement in their self-esteem and overall confidence.