Strabismus is the loss of parallelism between the eyes. Each eye has six extraocular muscles. A deficiency or excess of strength in one or more of these muscles causes strabismus. While one eye looks straight ahead, the other may drift inward, outward, upward, or downward. In some cases, strabismus is present in both eyes. Depending on the cause of strabismus, the misalignment can be permanent or temporary. There is no single cause for strabismus. Strabismus can develop for a variety of reasons.
Early diagnosis is crucial in the treatment of strabismus. Delaying the initial eye examination can lead to lifelong vision loss, as well as aesthetic problems in children's eyes. Even if children don't have any eye problems immediately after birth and throughout childhood, they should be examined regularly by an ophthalmologist.
Causes of Strabismus
There is no single cause for strabismus. A problematic pregnancy, a problematic birth, the child's development, and past illnesses can all lead to strabismus. There is also a genetic predisposition to strabismus. If there is a family history of strabismus, the likelihood of strabismus developing in children increases.
Strabismus that appear in childhood, after the age of 2, is usually caused by eye disorders. In a child prone to strabismus, the strabismus may begin after a fever or trauma (falls, surgeries, accidents).
The center that controls the movement of our eye muscles is in the brain, so paralysis of the nerves can also cause strabismus. Paralysis of the nerves supplying the eye can occur in some cases, such as accidents, head trauma, fevers, and advanced age with hypertension and diabetes. Treatment for such strabismus can vary depending on whether the paralysis is permanent. Because misalignments resulting from muscle paralysis can cause amblyopia in children and double vision in older adults, treatment is essential.
Symptoms of Strabismus
- Loss of parallelism in the eye
- Watering of the eyes
- Pain
- Headache
- Double vision
- Loss of three-dimensional vision
- Blurred vision
- Head or face turned to one side
Some strabismus occurring in infancy and childhood is called pseudostrabismus. A pseudostrabismus is a misleading appearance caused by the widening of the eyelids and the bridge of the nose. An eye examination is essential to fully elucidate this condition.
Consistent strabismus in one eye is a sign of decreased vision in that eye and is important. Therefore, infants and children with strabismus in one eye should be taken for an eye examination immediately.
What Should Be Done for Treatment?
Because strabismus stems from many causes, treatment varies from person to person. Strabismus is an eye problem that can be treated at any age.
Treatment with Glasses: Some types of strabismus occur due to a refractive error. The strabismus corrects itself when the patient begins wearing glasses. Glasses are sufficient for this type of strabismus.
Occlusion Therapy: This treatment method is used if the patient has a lazy eye.
Orthoptic Treatment: This treatment consists of eye exercises to restore the ability to see with both eyes and to perceive depth.
Surgical Intervention: Strabismus surgeries are most often performed on the muscles located outside the eyeball. To correct strabismus and ensure parallelism between the eyes, various techniques are used to increase or decrease the strength of these muscles, or to change their points of action.
Congenital strabismus is generally not a symptom requiring glasses and requires surgery early on (between 6 months and 1 year of age). The majority of strabismus occurs around 2–3 years of age and can usually be completely corrected with glasses. Strabismus that persists despite wearing glasses requires surgical treatment. Strabismus surgeries are usually performed under general anesthesia.
Early diagnosis and treatment of strabismus can prevent amblyopia and allow for three-dimensional vision. Therefore, any child suspected of having strabismus should be seen by a strabismus specialist ophthalmologist before reaching a certain age.