Non-operative treatment of strabismus in children

Strabismus is a disease that develops as a result of inappropriate eyeball alignment. Strabismus often shows up at birth. Usually it is associated with developmental disorders, but it should be remembered that strabismus may also appear later in human life. What are the methods of inoperable strabismus treatment?

What are the causes of strabismus in children?

There are many reasons for the development of strabismus in children. A baby’s vision develops very early in life, and is not fully developed right after birth.

Immediately after birth, the newborn’s vision is very limited because its sense of sight is not fully developed yet. Therefore, the newborn can still see out of focus, peripherally and, importantly, mainly in gray.

A baby’s eyesight develops and matures over many months. Therefore, strabismus in infants need not be a cause for concern, as it usually results from insufficient development of the eyes and their muscles.

Strabismus can unfortunately be one of the symptoms of serious diseases and defects in a child. If a baby has a tearing eye, it is important to get it checked by a specialist immediately. At the ophthalmologist, the child will have their visual acuity checked, and the doctor will be able to determine the type and size of the strabismus angle. Importantly, the doctor can also assess the structure of the eyeballs, and can indicate what exercises or treatment methods should be introduced.

Check: Zez – when to see a doctor?

What are the symptoms of strabismus in children?

The symptoms of strabismus in children are usually very visible, so it is very important to closely observe the child and pay special attention to the parallel positioning of the eyes. It is worth paying attention to whether the child is squinting his eyes, does not crook his eyes, or does not close one eye when looking at something. In case of any doubts, it is best to see a doctor immediately. Remember that strabismus is not only an aesthetic defect, but can also have specific health consequences.

In the case of children, we usually deal with convergent strabismus. This means that one or both of the baby’s eyes line up towards the nose. This usually applies to 2 and 3 year olds. This condition can cause hyperopia.

Strabismus may not be visible all the time at first, but it should be remembered that it may appear more often over time. If the child’s eyes diverge towards the temples, this is a sign of divergent squint. In this case, the problem is also not visible all the time at first. The child’s eyes or eye may diverge to the temple when, for example, the child is lost in thought.

Among other symptoms, strabismus in a child is associated with oblique strabismus. It results from the paresis of the upper oblique muscle. Oblique strabismus can be both congenital and acquired. A very characteristic symptom of oblique strabismus is an atypical compensatory head position. This means that the baby’s head is usually tilted towards the healthy eye, the baby turns its face in that direction or lowers its chin.

How to non-surgically treat strabismus in children?

The basis for strabismus is to start treatment as early as possible, therefore it is very important to diagnose the problem early. Parents should be concerned about incorrect head position, tilting the head to one side and squinting eyes.

There are many methods of treatment. The doctor always decides which method to choose. Among the non-operative methods, it is worth mentioning:

  1. properly selected corrective lenses – they are used when strabismus is the result of a visual defect in a child. Lenses can be ordinary or prismatic. Properly selected lenses can adequately reduce strabismus and even completely eliminate the problem of inappropriate eyeball positioning;
  2. pleoptic exercises – a method often used in the treatment of strabismus in children. It consists in forcing the child to look straight with a cross-eyed eye. For this purpose, the child’s healthy eye is covered with a special cover, which improves fixation in the sick eye. This method works for most children, but the effects depend on the child’s other comorbid conditions, such as amblyopia or polysightedness. The effectiveness of this method is also influenced by the age of the child at the time of diagnosis. Exercise should be performed about an hour a day. If it improves, the child is instructed to do another series of exercises. Treatment is completed when the vision is fully acuity. Treatment with pleoptic exercises can take many months;
  3. orthoptic exercises – these exercises are often combined with pleoptic exercises. This method of treatment aims to stimulate the visual centers in the brain and develop binocular vision. Thanks to the exercises, the work of the eyeball muscles is also to be improved. However, the exercises can be started only after achieving comparable visual acuity in both eyes. To achieve the desired results, exercise should be performed daily. If this is not possible, it must be performed at least twice a week;
  4. preparations of botulinum toxin – the cause of strabismus in children is sometimes excessive contraction of one of the muscles responsible for the movement of the eyeball. For this reason, in this case, injection of a specific muscle with preparations of botulinum toxin is used. To be effective, these treatments should be performed at regular intervals. This method is most effective in treating a residual defect.

If treatment is not working as expected, surgery should be considered.

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