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Strabismus is considered a disease. It consists in improper alignment of the eyeballs. The most common and easily noticeable symptom is the characteristic appearance of the baby’s eyes. Various disorders of monocular and binocular vision are also associated with strabismus. What are the treatments for this condition?
What is strabismus?
Strabismus is an incorrect and uneven positioning of the eyeballs. The condition is associated with inadequate control of the eye movement by the nerves and muscles. There are many types of strabismus. Due to the nature of the disorder, we can distinguish:
- unilateral strabismus – this means that the abnormal eye movement affects only one eye;
- alternating strabismus – this means that the strabismus occurs once in one eye and once in the other.
It is also worth mentioning the division of strabismus depending on the direction of the eyeball deviation:
- convergent strabismus – means the eyeball is tilted towards the nose;
- divergent strabismus – means the deviation of the eyeball towards the temple;
- strabismus upwards – means inclination towards the forehead;
- strabismus downwards – means inclination towards the chin;
- oblique strabismus – means upward or downward inclination.
Strabismus can also be divided into:
- hidden strabismus – the so-called invisible. It results from the occurring abnormalities in the tone of the oculomotor muscles. In this case, the strabismus may appear when binocular vision is impaired, which can happen during times of stress or fatigue;
- accompanying open squint – means visible abnormal position of the eyeball;
- open squint not accompanying – the so-called paralyzed. Its main feature is impaired motility of the eyeball. The eye turns to the affected muscle, movement is impaired or impossible.
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What are the reasons for the appearance of strabismus?
Among the causes of strabismus, it is worth mentioning:
- refractive disorders;
- diseases of the eyeball or orbit;
- oculomotor muscle diseases;
- diseases of the innervating nerves;
- diseases of the central or peripheral nervous system.
In addition, the development of strabismus is favored by:
- genetic predispositions;
- somatic causes of unknown origin.
Why is it always necessary to see an ophthalmologist in the case of strabismus?
Strabismus may appear in newborns. However, the disease may develop within a few or several weeks. In very young children, the symptoms of strabismus appear very quickly, which results from the characteristic and high dynamics of the development of the child’s brain structures. The later the strabismus is diagnosed, the more negative the disease affects the child’s development. It is worth remembering that strabismus is always a symptom that should make us visit an ophthalmologist, and an ophthalmological examination is recommended immediately after noticing an incorrect position of the eyes.
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What are the treatments for strabismus?
Strabismus requires a quick introduction of a properly selected form of treatment. There are two basic methods of treatment:
- conservative treatment – this form of treatment is aimed at improving the visual condition of the squinted eye. In addition, this eye is to develop a central fixation and correct visual localization. This will be achieved thanks to:
- correcting the visual defect thanks to vision correction through glasses or lenses;
- prism glasses or prism foils;
- treating amblyopia using obstruction or penalisation;
- visual rehabilitation – these are pleoptic and orthoptic exercises;
- surgical treatment – this treatment is aimed at parallel positioning of the eyes. This goal is achieved through:
- injections of botulinum toxin into specific muscles to weaken their tension;
- operations in the field of oculomotor muscles – these operations are aimed at weakening or strengthening specific muscles in the affected eye.
- correcting the visual defect thanks to vision correction through glasses or lenses;
- prism glasses or prism foils;
- treating amblyopia using obstruction or penalisation;
- visual rehabilitation – these are pleoptic and orthoptic exercises;
- injections of botulinum toxin into specific muscles to weaken their tension;
- operations in the field of oculomotor muscles – these operations are aimed at weakening or strengthening specific muscles in the affected eye.
The most effective treatment should combine several methods. A very important element of it is the cooperation of the child’s parents or guardians with the ophthalmologist and, of course, strict and consistent compliance with the rules and recommendations of the doctor.
The treatment of hidden strabismus is not necessary only when the strabismus does not cause troublesome symptoms. In the case of paralytic strabismus, treatment is based on multi-specialist removal of the cause of the strabismus. Treatment is based on the cooperation of a neurologist, neurosurgeon, endocrinologist, internist and even a maxillofacial surgeon. The task of the ophthalmologist in this case is to relieve symptoms.
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What is the surgical treatment of strabismus in children?
Surgical treatment of strabismus is very common. The decision is made mainly in the case of oblique, vertical or large-angle strabismus. Treatment is based on strengthening the weak muscles and weakening the stronger ones. As with other methods of treatment, surgery performed as early as possible gives the best chance of achieving satisfactory results. Experts recommend that the procedure be performed before the age of 10. This gives the eyeballs the best chance for them to return to their correct position and be properly positioned.
How is strabismus surgery performed in children?
Before the doctor performs the strabismus operation and makes the decision, he must carefully assess the patient’s visual defect and his binocular vision. Before the procedure is performed, the interview is also conducted by the anaesthesiologist, because the operation is performed under full anesthesia.
During surgery, the doctor performing the procedure cuts the outer wall of the eye to regulate the tension of the external muscles on the eye or eyes. It happens that the doctor also performs a resection to shorten the eye muscles and set them in the right position. After the operation, the doctor puts a one-day dressing on the eye.
After surgery, the eye remains red for several days. There is also swelling and lacrimation. For the next few weeks, the patient should use anti-inflammatory drops and avoid exercise and contamination of the eye. After the procedure, the doctor sets a schedule for follow-up visits.
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