Strabismus or crossed eyes refer to the condition in which your eyes do not line up with one another. Simply put, one eye is turned in a direction while the other one is not. Normally, the six muscles in charge of controlling eye movement, work together and point both eyes in the same direction. Those with strabismus, have trouble controlling eye movement and can’t keep normal ocular alignment. Based on the direction of the turn, strabismus can be categorized as:
Inward turning (esotropia)
Outward turning (exotropia)
Upward turning (hypertropia)
Downward turning (hypotropia)
What causes Strabismus?
The eye condition known as Strabismus usually results from an abnormality of the neuromuscular control of eye movement. However, the understanding of these control centers is still evolving. Strabismus is usually in your genetics since about 30% of children with this situation have a family member with a similar problem. Other conditions associated with strabismus include:
Uncorrected refractive errors
Poor vision in one eye
Cerebral palsy
Down syndrome (20-60% of these patients are affected)
Hydrocephalus (a congenital disease that results in a buildup of fluid in the brain)
Brain tumors
Stroke (the leading cause of strabismus in adults)
Head injuries can damage the area of the brain responsible for control of eye movement, the nerves that control eye movement, and the eye muscles
Neurological (nervous system) problems
Graves' disease (overproduction of thyroid hormone)
When do Strabismus symptoms appear?
The infant’s eyes should be able to focus on small objects by the age of 3-4 months. So they should have straight and well-aligned eyes. By the age of 6 months old, infants should be able to focus on objects both near and far. It’s important to check for signs, since strabismus mostly appears in infants and young children, usually by the time a child turns 3 years old. That doesn’t mean older children or even adults can’t develop strabismus.
How is Strabismus diagnosed?
If an infant older than 4 months, has trouble aligning their eyes, they should have a complete eye examination, by a pediatric ophthalmologist. This exam may include:
Patient history: To determine the symptoms the patient is having, family history, general health problems, medications being used, and any other possible causes of symptoms.
Visual acuity: Reading letters from an eye chart, or examining young children’s visual behavior.
Refraction: Check the eyes with a series of corrective lenses to measure how they focus light.
Alignment: & focus tests
Examination after dilation: Widening of the pupils to determine the health of internal eye structures.
How can strabismus be treated?
Eyeglasses or contact lenses: If the patient has uncorrected refractive errors, corrective lenses help the eye need less focusing effort so they may remain straight.
Prism lenses: These are special lenses to bend the light entering the eye and help reduce the eye’s need to turn, in order to look at objects.
Orthoptics (eye exercises): These exercises may work on some types of strabismus, especially convergence insufficiency.
Medications: Eye drops or ointments. Which may be used with, or in place of, surgery, depending on the patient's situation.
Patching: If a patient has amblyopia (lazy eye) as well as strabismus, this form of treatment is used.
Eye muscle surgery: Surgery changes the length or position of eye muscles so that the eyes are aligned correctly. Some adults are offered adjustable strabismus surgery, where the eye muscle positions are adjusted after surgery.
What happens if Strabismus is not treated?
Some believe that children will outgrow strabismus or that it will get better on its own. But the fact remains, if left untreated it can get worse. Eyes that are not properly aligned may cause:
Lazy eye (amblyopia) or permanent poor vision in the turned eye. Since the eyes are looking in different directions, they’ll send 2 images to the brain, the brain may ignore the image from the turned eye to avoid double vision, which will result in poor vision development in that eye.
Blurry vision
Eye strain
Fatigue
Headaches
Double vision
Poor 3D vision
Low self-esteem (from feeling ashamed of one’s appearance)
In rare cases, serious issues (such as brain tumors) may be causing this condition and undiagnosed strabismus may cause it to be overlooked.
What to expect after strabismus treatment?
In younger patients, if strabismus is caught in time and properly treated, they may have excellent vision and depth perception. Also, patients will need to make follow-up appointments, to see how well they’ve responded to treatments.
Conclusion
In conclusion, strabismus is a common eye condition characterized by misalignment of the eyes due to imbalances in the muscles responsible for eye movement. It can occur in both children and adults and may result in symptoms such as double vision, eye strain, and difficulties with depth perception. Strabismus can also have psychosocial impacts due to the noticeable misalignment of the eyes. Fortunately, there are effective treatments available, including glasses, vision therapy, and surgery. Early detection and treatment of strabismus are crucial to prevent long-term vision problems and improve quality of life. Ongoing research continues to enhance our understanding and management of this complex condition.
Read more: