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Strabismus

Strabismus

What is strabismus? It is a form of convergence insufficiency involving the eyes. In a nutshell, strabismus is cross-eyes (esotropia). The eyes point in different directions, whether up, down, out, or in, and may be consistent or random. One eye may look to the side while the other eye looks straight, or they could point to each other. Each time it happens, the direction may be different.

Strabismus affects roughly two to four percent of children. It is a problem that typically does not resolve on its own. How do you correct it? It depends on what causes the eyes to cross or the type of eye movement you experience.

Not every treatment is appropriate for everyone, and there is no guarantee of 100% recovery. There are a few treatment options that are effective in most cases that don’t require surgery. You and your optometrist can discuss which is appropriate for you.
Through this article, you will learn about the most common types of strabismus, what causes it, symptoms you may encounter, and treatment options available.

Types of Strabismus

The two most common types of strabismus are accommodative esotropia and intermittent exotropia.

Accommodative Esotropia

During accommodative esotropia, the eyes work extra hard to focus on an object that is too close. If it happens often, it can lead to the crossing of the eyes. Most patients who struggle with accommodative esotropia are far-sighters, meaning they can’t see closeup.

Children who begin life with crossed eyes won’t experience normal eye development and should see an optometrist. The first treatment for accommodative esotropia is glasses or contact lenses, so the eyes don’t have to work so hard to focus.

Intermittent Exotropia

If one of your eyes remains focused on a particular object while the other eye looks outward, you may be experiencing intermittent exotropia. It can affect people of any age. Some patients exhibit symptoms while others don’t.

Trouble reading due to eye strain, double vision, or photosensitivity is a common symptom. Headaches may be indicators of intermittent exotropia. There are different ways to treat this form of strabismus. The treatment options are below.

Causes of Strabismus

Some causes of Strabismus are unknown. Heredity plays a significant role in the development of strabismus. Some children are born with it. If you have one child with strabismus, your other children will likely have it too. Congenital defects, such as Down syndrome, hydrocephalus, or neurological disorders, may be contributing factors.

Sustaining a head injury as a child could trigger it. Damage to the orbital region or nerves can lead to the development of strabismus. Thyroid disorders, namely thyroid eye disease (TED), can affect the functioning of the eyes. In some cases, crossed eyes can occur later in life.

Symptoms of Strabismus

A common symptom of strabismus is diplopia or double vision. Lazy eyes (amblyopia) can form if your eyes do not line up correctly in childhood and your vision becomes affected. A lazy eye is your body’s way to avoid seeing double.
Strabismus is common in children. Symptoms are not always evident. Here are some common ways to tell if your child may be experiencing strabismus:
  • The eyes wander in an outward or inward direction
  • The child tilts his head or squints to see something more clearly
  • The presence of red light reflection is visible in one eye
  • The child may appear to have poor depth perception and stumble often.
Adults can develop symptoms resulting from trauma to the body, such as a stroke, head injury, or poor health conditions. Diabetes, thyroid problems, and eye diseases are common causes.

Treatments

Early detection and treatment are crucial to prevent debilitating or loss of vision. Common ways are correcting the vision with glasses or contact lenses, eye patches, or vision therapy.

Corrective Lenses

Glasses or contact lenses are typically an initial form of treatment. Corrective lenses decrease the workload of the eyes so they can relax and learn to straighten up. Prism lenses are the most common form of corrective eyewear. The lens on the affected side is thicker to let in less light and reduce the movement of the faulty eye.

Eye Patches

Eye patches are effective on patients who experience lazy eyes along with the strabismus. The purpose of the patch is to divert attention from the normal eye and allow the brain to receive information through the affected one. The brain teaches the eye muscles how to re-align properly.

Vision Therapy (VT)

Other treatments may not be appropriate for you or your child. Glasses or eye patches may be embarrassing to a child and get in the way of regular activities. The most effective way to correct strabismus is through Vision therapy (VT).

Vision therapy is an individualized method of treatment that is scientifically proven to correct strabismus and other visual deficits. Strabismus does not affect the eye muscles, so there are no exercises. An optometrist uses neuroplasticity to retrain the brain to adjust to new changes after injury.

Neuroplasticity stimulates the brain’s neurons by forming new channels around the injured area and restoring function. Through a variety of techniques, the patient learns to control eye movement and focus. VT does not conclude in the office. You will have to do some exercises at home between sessions.

Over several sessions, the eyes will learn to work together and improve your vision. Visual therapy is especially beneficial to patients who have suffered a stroke or traumatic injury to the eyes.
Children receive vision rehabilitation to correct strabismus caused by a variety of factors. Those with a lazy eye, crossed eyes, and vision disturbances from developmental disorders respond well to therapy treatments.

Effects of Vision Therapy

Visual therapy works if the patient is willing to cooperate with the therapist and the activities. Many optometrists find that adults respond better to vision therapy than children because they are more motivated to follow instructions and do the homework. The National Eye Institute (NIE) revealed positive results in about 75% of patients who participated in visual therapy in the office.

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