How long does it take for binocular vision to recover after strabismus surgery, and is it normal to still have issues at 5 weeks?

It is completely understandable to feel concerned at this stage, but what you’re describing is actually quite common after strabismus surgery
Especially when both horizontal and vertical components were involved.

From a clinical perspective, 5 weeks is still early in the healing and adaptation phase.
While the muscle alignment  may look good already, the brain-eye coordination (binocular vision) often takes significantly longer to stabilize.

Here’s what typically happens:

• Your eyes being straight is a very positive sign. However, achieving comfortable common vision depends on how well your brain relearns to use both eyes together. This can take 6–12 weeks or even several months.
• Vertical alignment is generally harder to fully correct than horizontal. It’s not unusual for there to be some residual imbalance early on, which may gradually improve as healing continues.
• The prism is helping your brain fuse the images while your system adapts. Many patients need prisms temporarily, and in some cases, the need reduces over time.
• Controlling eye alignment at distance requires more precise coordination, so symptoms like – difficulty keeping eyes together, mild double vision, dizziness or visual discomfort are common during this phase.
• These symptoms often come from the brain adjusting to a new visual input. They usually improve gradually, but it can feel unsettling in the meantime.

When improvement typically occurs

• Noticeable adaptation: 6–8 weeks onward
• Continued improvement: up to 3–6 months
• Final stability: sometimes 6–12 months

When to follow up

You should stay in touch with your ophthalmologist, especially if:

• Symptoms are not improving at all over the next few weeks
• Double vision worsens
• Dizziness becomes severe or persistent

They may adjust your prism prescription or recommend vision therapy (orthoptics) to help your brain fuse images more effectively.