Surgery to the horizontal rectus muscles and lateral rectus muscle is commonly performed, whereas surgery to the vertical rectus muscles is uncommon. The operation begins with the incision of the conjunctiva. Procedures that weaken muscle actions are rectus muscle recession, Hang-back technique recession and elongation of the muscle by myotomy and myectomy. Rectus muscle recession is indicated in weakening medial rectus in esotropia unilateral or bilateral and for weakening lateral rectus in exotropia unilateral or bilateral. Hang-back technique recession is indicated in weakening rectus muscle in case of the difficult access in the young baby and if very large recession is required and in use of adjustable sutures. Elongation of the rectus muscle comprises cutting tendinous part or muscle body to elongate it and in consequence weaken muscle actions. It is indicated in weakening of secondary contracted muscle in paretic squint, minimal surgical intervention is required on previously operated globe, following retinal ablation, ocular trauma, high myopia or other weakening of eyeball walls.