Strabismus

 

Strabismus

Definition

Strabismus, which is not a disease but a visual disorder, is the deviation of an eye relative to the other, there are different kinds:

  • Esotropia corresponds to a convergent strabismus: one eye deviates inward.
  • Esotropia corresponds to a divergent strabismus: one eye deviates outward.
  • Hyperopia corresponds to a high position: a look deflects upwardly.
  • Hypotropia corresponds to a low position: a look deflects downward. 

 

Symptoms

  • Deviation of the eye alignment.
  • Children rarely complains itself of an anomaly.
  • Adults who develop strabismus has diplopia (double vision). 

 

Frequency

 

Strabismus affects about 5% of children, both girls and boys, and amblyopia, poor vision in one eye, is associated in half of cases.

In 80% of cases, strabismus begins before the age of 2 years. 

Translated from Opthalmologie

 

Causes

In any case, the existence of a family history of strabismus is largely determinative because the genetic factor is amply demonstrated. Include a family history of strabismus in 50 to 80% of cases.

Translated from Ophtalmologie 

Focus of vision problems (such as hyperopia) can also cause strabismus.

Mechanical causes may be responsible for a squint, when the eye muscles are limited in their movements.

 

Evolution

The most serious consequence of strabismus is the eye that fixes will spontaneously take dominance and work alone while the other eye, the deviated eye will not be applied, will gradually lose its visual function and become amblyopic.

Translated from Ophtalmologie

 

Diagnosis

For a strabismus diagnosis, you will visit an eye doctor who will perform a series of tests to check the health of your eyes, including a:

  • corneal light reflex test to check for crossed eyes
  • visual acuity test to determine how well you can read from a distance
  • cover/uncover test to measure deviation and eye movement
  • retina exam to examine the back of your eyes

Early diagnosis is important for preventing vision loss. In young children, it is best to have an eye exam before age 3. If other physical symptoms appear along with crossed eyes, your doctor may examine your brain and nervous system for the presence of other conditions, such as cerebral palsy or Guillain-Barre syndrome.

Source : HealthLine

 

Treatment

Treatment for strabismus works to straighten the eyes and restore binocular (two-eyed) vision. In some cases of strabismus, eyeglasses can be prescribed for your child to straighten the eyes. Other treatments may involve surgery to correct the unbalanced eye muscles or to remove a cataract. Patching or blurring the strong eye to improve amblyopia is often necessary.

Very young children with esotropia usually require surgery to realign the eyes.

For accommodative esotropia, glasses reduce the focusing effort and often straighten the eyes. Sometimes bifocals are needed for close work. If significant crossing of the eyes persists with the glasses, surgery may be required.

With exotropia, though glasses, exercises, patching or prisms may reduce or help control outward-turning of the 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 surgery. The ophthalmologist makes a small incision in the tissue covering the eye to reach the eye muscles.

The eye muscles are detached from the wall of the eye and repositioned during the surgery, depending on which direction the eye is turning. It may be necessary to perform surgery on one or both eyes.

Recovery time is rapid. Children are usually able to resume their normal activities within a few days.

After surgery, glasses may still be required. In some cases, more than one surgery may be needed to straighten the eyes. 

Source : AAO

 

Images

  Child exhibiting uncorrected accommodative esotropia

Esotropia-uncorrected

SourceBy Sandra Brown, M.D. - University of Michigan Kellogg Eye Center (The Eyes Have It) [CC BY 3.0], via Wikimedia Commons

 

Exotropia of right eye

Štenclová-Ivana-Exotropia

SourceBy NoJin (Štenclová-Ivana-2012.jpg) [CC BY 3.0], via Wikimedia Commons

 

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