My daughter was diagnosed at age 2. Now just a month shy of 14 she about to have her first surgery. The reason for surgery the degree of her head tilt and her amount of double vision; are to a point were it will impair her present and furture functions. We have never been given a surgery option for cosmetic reasoning. However, she has compensated rather well all her life, makes straight A's and plays the flute, with no problem reading sheet music. Yes she has had to make choices unlike other kids in order to keep her marks in check, like always sitting on the left side of the room. But I can't imagine that Duanes would be the cause for not making superior marks in school.