Strabismus Diagnosis and Treatment

In healthy individuals, both eyes work parallel and in harmony. The disruption of this parallelism between the eyes due to various reasons is called strabismus. In individuals with strabismus, while one eye looks straight, the other eye drifts upward, downward, inward, or outward. In more severe cases, both eyes may drift simultaneously. Depending on the cause of strabismus, these drifts can be temporary or permanent.

 

Strabismus is a condition that usually occurs in childhood. The most basic symptom of the disease is an eye that does not look straight. Individuals with strabismus, when looking at a point, have one eye straight while the other eye drifts to a different angle. In children, strabismus may reveal itself with behaviors such as closing one eye in sunlight or adopting an abnormal head position to use both eyes. Apart from these, common symptoms of strabismus include;

• Watery eyes

• Head and eye pain

• Double vision

• Loss of three-dimensional vision ability

• Looking by turning the head and eyes to one side

• Blurred vision

 

Strabismus diagnosis can be easily made as a result of a clinical eye examination. Early diagnosis is very important in the treatment of strabismus. If the first eye examination is delayed, children may develop lifelong vision impairment problems in addition to aesthetic problems. With early diagnosis and treatment of strabismus, amblyopia can be prevented, and three-dimensional vision can be achieved. Even if children do not have eye complaints, they should be regularly examined by an ophthalmologist starting right after birth and during childhood.

 

Since strabismus can be caused by many reasons, treatment varies from person to person. Strabismus is a treatable eye problem at any age. The treatment methods for strabismus include;

-Treatment with Glasses: Some types of strabismus are caused by refractive errors. When the patient starts using glasses, strabismus corrects itself. Glasses are sufficient for this type of strabismus.

-Occlusion Therapy: This treatment method is applied if there is amblyopia in the patient's eye.

-Orthoptic Treatment: This therapy consists of exercises applied to the eye to restore the ability to see with both eyes and the sense of depth.

-Surgical Treatment: Strabismus surgeries are performed on the muscles outside the eyeball. Various techniques are used to strengthen, weaken, or change the action points of these muscles to correct strabismus and achieve parallel alignment between the eyes.

Congenital deviations usually do not require glasses and need to be surgically corrected in the early period (6 months - 1 year). Most eye deviations appear around 2-3 years of age and usually can be fully corrected with glasses. For deviations that do not improve despite wearing glasses, surgical treatment is required.

-Botox Treatment: When botulinum toxin is injected into the muscle causing the deviation, alignment in the eyes is achieved. Its effect lasts about 6 months and is a preferred treatment method in special cases like nerve paralysis-related strabismus. The general tendency is to wait 6-8 months in these types of strabismus, but Botox can be applied during the waiting period to reduce double vision.

 

When is Strabismus Dangerous?

Although strabismus is sometimes seen only as an aesthetic problem, especially when it occurs in childhood, it can lead to permanent visual impairments. Amblyopia is one of the most serious outcomes of strabismus. As one eye is used less than the other, it is perceived by the brain over time as "not seeing," which can lead to permanent vision loss.

Strabismus developing later in adults can often be a sign of another underlying neurological problem. Strabismus occurring together with sudden double vision, headaches, or drooping eyelids should be evaluated immediately. In such cases, serious conditions such as brain tumors, nerve palsies, or vascular blockages should be investigated.

Can Strabismus be Corrected with Glasses?

The use of glasses in strabismus treatment, particularly in inward deviations due to hypermetropia, provides quite successful results. In strabismus caused by such refractive errors, the parallelism between the eyes can be achieved when glasses are worn, possibly eliminating the need for surgery. However, glasses may not be sufficient for all types of strabismus.

For deviations not corrected with glasses, additional treatments are generally required. Therefore, before starting glasses therapy, the risk of amblyopia is assessed, and, if necessary, it is combined with occlusion therapy. Especially in children, regular check-ups along with glasses use are of great importance.

Misconceptions About Strabismus

There are many misconceptions about strabismus in society. For example, the belief that "Strabismus is only treated in childhood, it is not possible in adults" is incorrect. Thanks to advancing surgical and Botox methods today, strabismus can be successfully treated at older ages too.

Another misconception is the statement "Strabismus will correct itself over time." Some physiological drifts may be temporary in the initial months, but most types of strabismus do not correct themselves. Early intervention is essential to prevent the development of amblyopia.

Strabismus can create psychological and social effects, not just visual ones. Therefore, the early diagnosis of strabismus, correct information, and timely treatment provide both aesthetic and functional benefits.

Frequently Asked Questions

What Causes Strabismus?

Strabismus is the condition of one eye drifting inward, outward, upward, or downward while the other looks straight due to the disruption of parallel alignment of the eyes.
The most fundamental answer to what causes strabismus is the imbalance between the eye muscles. This imbalance may be congenital or due to trauma, neurological diseases, or visual defects developed later.
Strabismus that appears in childhood is generally due to congenital factors or refractive errors. In adults, conditions such as cerebrovascular diseases, diabetes, and high blood pressure can also lead to strabismus.

What is Strabismus?

Medically known as "strabismus," it is the condition where both eyes cannot focus on the same point. Due to the lack of coordination of the eye muscles, while one eye focuses on the target, the other eye looks in a different direction.
Strabismus may cause both aesthetic and functional issues. If not treated during childhood, amblyopia may develop.
In some cases, eye strabismus can be a mild condition only noticeable when fatigued. In such conditions, early diagnosis and regular follow-up are very important.

How can Strabismus be Treated?

How to treat strabismus is one of the most intriguing questions concerning treatment. Strabismus treatment varies based on the degree, duration, and underlying cause of the deviation.

Treatment methods:

• Use of glasses (especially in hypermetropia)

• Occlusion therapy (to prevent amblyopia)

• Eye exercises

• Prismatic glasses

• Strabismus surgery (in permanent deviations)

In some situations, a strabismus test is conducted to thoroughly assess the function of the eye muscles. Surgery may be necessary in patients who do not respond successfully to non-surgical methods.

How Long Does Strabismus Surgery Take?

The question of how long strabismus surgery takes is one of the most curious details for patients before the procedure. This surgery generally lasts between 30 minutes to 1 hour.
The duration of the operation may vary depending on the number of muscles involved and the severity of the strabismus. It can be performed under local or general anesthesia.
The patient can often be discharged the same day after strabismus surgery. The recovery period is rapid but may include redness, mild stinging, or watering in the eyes for a few days.
The success rate of the surgery is quite high, but additional surgery may be required in some cases.

Strabismus Surgery Costs

Strabismus surgery costs can vary based on the equipment of the health center, the expertise of the surgeon, and the techniques to be used.

Factors affecting the cost:

• Number of eye muscles to be operated on

• Choice of general or local anesthesia

• Post-operative follow-up services