Strabismus is a condition that causes each eye to look in different directions; this condition is due to the lack of coordination between the eye muscles. It occurs when one eye focuses on the target while the other deviates to the right, left, upward, or downward. Although common in early childhood, strabismus can also develop in adulthood. If strabismus symptoms are observed, a specialist should be consulted without delay.
What is Strabismus?
Under normal conditions, both eyes focus on the same point, transmitting a single image to the brain. In strabismus, this alignment is disrupted, delivering two different images to the brain. This can lead to double vision, headaches, or amblyopia.
Types of Strabismus:
-
Esotropia: Inward deviation type of strabismus, where one eye turns inward in relation to the other, causing alignment problems. The person may struggle to see distant objects clearly.
-
Exotropia: In exotropia, or outward deviation, one eye turns outward compared to the other, potentially causing vision problems. Focusing on nearby objects may become difficult.
-
Vertical strabismus: Eyes may deviate upward or downward. This type of strabismus is generally rarer and may require special treatment.
-
Microstrabismus: Very slight misalignments, known as microstrabismus, may also occur. There may not be apparent symptoms but treatment might still be necessary.
At What Ages Does Strabismus Occur?
Strabismus is generally observed in children aged 0-7. However, it can also occur in adults due to nervous system disorders, trauma, or certain muscular problems.
If amblyopia is not diagnosed early in childhood, treatment becomes difficult in later ages. Hence, if strabismus symptoms are detected in children, it is important to consult a specialist immediately.
In adults, the symptoms of strabismus typically present as double vision and a decreased quality of life, especially in progressive cases, making daily activities challenging.
How is Strabismus Diagnosed?
The diagnosis of strabismus is made through a detailed examination by an expert ophthalmologist. In pediatric patients, the diagnostic process should be carried out with special methods and patience.
Methods used in the diagnosis of strabismus:
-
Eye alignment tests (cover-uncover test): This test helps determine the alignment of both eyes and the presence of strabismus.
-
Prism tests: These assess the balance between the eyes and help determine the degree of strabismus.
-
Examination of eye muscle movements
-
Visual acuity measurement: Used to determine how clearly the patient's eyes can see separately or together.
-
Binocular vision tests: These assess the balance between the patient's two eyes. These tests reveal whether both eyes work in harmony and provide insights into the ability to perceive three-dimensional vision.
-
Amblyopia (lazy eye) screening
Early intervention is crucial since untreated amblyopia can lead to permanent vision loss when not diagnosed and treated at an early age. These screenings help protect the visual health of children and support their development.
What are the Causes of Strabismus?
Various factors contribute to the development of strabismus.
-
Genetic factors: Individuals with a family history of strabismus are at higher risk.
-
Refractive errors: Eye disorders like hyperopia can lead to strabismus. If the eye cannot focus clearly, misalignment of eye muscles in different directions may develop strabismus.
-
Imbalance in eye muscles: If the eye muscles do not work properly, it can become difficult for the eyes to focus on the same point, leading to strabismus.
-
Developmental brain structure disorders: Disorders in brain development structures and nerve palsies can also cause strabismus.
-
Nerve palsies: Issues in areas of the brain that control eye movements or disorders related to the nervous system can increase the risk of strabismus.
-
Birth trauma, prematurity: Traumas during birth, conditions of premature birth like prematurity, and eye injuries are also factors that can cause strabismus.
-
Eye injuries
-
Systemic diseases: Conditions like diabetes, tumors, or infections can negatively affect body balance and eye health, potentially leading to strabismus.
Treatment of Strabismus in Children
The treatment plan is determined based on the child's age, the type of strabismus, and the presence of concurrent amblyopia.
Treatments applied:
-
Eyeglass use: Effective in strabismus related to hyperopia.
-
Prism lenses: May temporarily correct visual alignment.
-
Treatment of amblyopia: Treatments involve covering the healthy eye to stimulate the lazy eye.
-
Eye exercises: Strengthen eye muscles to support alignment.
-
Botulinum toxin application: Often preferred as an alternative to surgery, especially in younger age groups.
-
Strabismus surgery: Alignment is achieved through surgical intervention on the muscles. Generally applied in children aged 3 and above.
Treatment of Strabismus in Adults
In adults, strabismus often comes to attention due to aesthetic concerns as well as issues like double vision, difficulty focusing, and reduced visual comfort. Treatment plans are created based on underlying causes.
Treatment options:
-
Glasses and prism lenses: Particularly used to prevent double vision.
-
Eye exercises: Can be supportive especially in problems focusing on close distances.
-
Botulinum toxin application: Used temporarily to balance eye muscles.
-
Strabismus surgery: Surgical intervention to correct the position of the muscles. Provides effective results both aesthetically and functionally.
-
Multidisciplinary approach in neurologically sourced strabismus: Neurological support may be required in strabismus cases caused by nerve paralysis.
Frequently Asked Questions
How is the eye patch treatment applied in strabismus?
Eye patch treatment is typically applied to prevent or treat amblyopia in children. The healthy eye is covered with a special patch for certain periods, thereby stimulating the weaker eye to enhance visual development. The application duration varies depending on the child's age, strabismus degree, and the level of amblyopia.
Is strabismus only seen in infants and children?
No, strabismus can occur in any age group. It can develop in childhood and also occur in adulthood due to factors such as trauma, nerve palsy, tumors, or diabetes.
Does strabismus resolve on its own?
Some transient deviations may correct themselves spontaneously. Persistent strabismus generally requires treatment and can lead to permanent issues like amblyopia.
What should be done if eye deviation is noticed in infants?
Temporary eye deviations in the first 3-4 months can be considered normal in infants as they might relate to the developing visual system. However, if deviation is constant or continues beyond the 6th month, a consultation with an eye doctor is necessary. Early diagnosis is crucial for preventing amblyopia and ensuring healthy visual development.