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Free Laser Vision Screening
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Strabismus is a visual defect in which the eyes are misaligned and point in different directions. One eye may look straight ahead, while the other eye points inward, outward, upward or downward. Strabismus is a common condition among children. About 4% of all children in the United States have strabismus. It can also occur later in life. You, as a parent, may always notice the misalignment, or it may come and go. The turned eye may straighten at times and the straight eye may turn. How do the eyes work together?With normal vision, both eyes aim at the same target. The brain then fuses the two pictures into a single image. This three-dimensional image gives us depth perception. When one eye turns, two different pictures are sent to the brain. In an adult, this
often causes double vision. In a young child, however, the brain can ignore the image of
the misaligned eye and pay attention only the image from the straight or better-seeing
eye. The child then loses depth perception. Additionally, the child may develop amblyopia,
or a lazy eye. AmblyopiaGood vision develops during childhood when both eyes have normal focus and alignment. Strabismus may cause permanant reduced vision, or amblyopia, in the weaker eye. The brain will recognize the image of the better-seeing eye and learn to ignore the image of the weaker or amblyopic eye. This occurs in approximately 50% of the children who have strabismus. Amblyopia can be treated by patching the "good" eye to strengthen the "lazy" eye. If amblyopia is detected in the first few years of life, treatment is usually successful. Patching the eye to treat amblyopia is most successful when the child is preschool age. If treatment is delayed until later, amblyopia usually becomes permanent. As a rule, the earlier amblyopia is treated, the better the result. What causes strabismus?The exact cause of strabismus is not fully understood. Six eye muscles are attached to the outside of each eye. In each eye, two muscles move
the eye right or left. The other four muscles move it up or down and rotate it. To line up
and focus both eyes on a single target, all of the muscles in each eye must be balanced.
In order for the eyes to move together, the muscles in both eyes must be coordinated.
A pediatric cataract or eye injury that affects vision can also cause strabismus of the young. What are the symptoms of strabismus?The main symptom of strabismus is an eye that is not straight. Sometimes children will squint one eye in bright sunlight or tilt their head to use their eyes together. How is strabismus diagnosed?Strabismus can be diagnosed during an eye exam. It is recommended that all children have their vision checked by their pediatrician, family doctor or ophthalmologist (medical eye doctor) at or before their fourth birthday. How is strabismus treated?Treatment for strabismus works to:
After a complete eye examination, an ophthalmologist can recommend appropriate
treatment. In some cases, eyeglasses can be prescribed for your child. Other treatments
may involve surgery to strengthen or weaken the unbalanced eye muscles or to remove a
cataract. Covering or patching the strong eye to improve amblyopia is often necessary. EsotropiaEsotropia, where the eye turns inward, is the most common type of strabismus in infants. Young children with esotropia do not use their eyes together. In most cases, early surgery can align the eyes. Accommodative esotropiaAccommodative esotropia is a common form of esotropia that occurs in farsighted
children two years or older. ExotropiaExotropia, or an outward turning eye, is another common type of strabismus. This occurs most often when a child is focusing on distant objects. The exotropia may occur only from time to time, particularly when a child is daydreaming, ill or tired. Parents often notice that the child squints one eye in bright sunlight. Although glasses, exercises or prisms may reduce or help control the outward turning eye in some children, surgery is often needed. How is strabismus surgery done?The eyeball is never removed from the socket during any kind of corrective eye surgery. The ophthalmologist makes a small incision in the tissue covering the eye to reach the eye muscles. Certain muscles are strengthened or weakened during the surgery, depending on which direction the eye is turning. It may be necessary to perform surgery on one or both eyes, and surgery may be required more than once. When strabismus surgery is performed on children, a general anesthetic is required. Local anesthesia is an option for adults. Recovery time is rapid. People are usually able to resume their normal activities within a few days. After surgery, glasses or prisms may be useful. In many cases, further surgery may be needed at a later stage to keep the eyes straight. As with any surgery, eye muscle surgery has certain risks. These include:
Strabismus surgery is usually a safe and effective treatment for eye misalignment. It is not, however, a substitute for glasses or amblyopia therapy. |
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