The use of topical anesthesia for strabismus surgery can be useful in selected, cooperative patients. This technique is always performed on an ambulatory basis, and the surgical time rarely exceeded 30 minutes. One of the major advantages of this type of procedure is the ability to adjust the sutures during the operation. The presence of diplopia is a major indication for topical anesthesia. The use of Gracis grids has proved extremely useful for assessing the dynamic evolution of the diplopia over the various visual fields during the operation. This allows the surgeon to better control his correction, with horizontal, vertical, or torsional diplopia. Finally, this study shows that a precise clinical examination allows excellent results while limiting surgery to a single muscle (in 12 of the 14 cases).