Surgical treatment of strabismus in children

Strabismus can have many causes. The problem may be due to a problem in the muscles responsible for the movement of the eyeballs. Therefore, the viewing angle in one eye changes relative to the other. However, it can also be caused by hereditary diseases, infections that cause inflammation, and even eye cancer.

Strabismus is a disease that, if left untreated, can have serious health consequences. The disease is caused by incorrect alignment of the eyeballs in relation to the visual axis. This means that the baby’s eye or eyes will “run” towards the nose or temple. One of the methods of treatment is surgery. What is the procedure?

What are the causes of strabismus?

There may be several causes of strabismus in children. A child’s eyesight is formed at a very early stage of development, therefore, when a child is born, this sense is not fully developed yet. After birth, the baby perceives all visual stimuli, but they are very limited, the image is out of focus and in grays.

A child’s eyes mature for many months, therefore strabismus in the period of newborns and early infancy is normal, but it should be monitored. Strabismus at this stage is caused by insufficient development of eyesight and eye muscles.

However, it should be remembered that strabismus can be a symptom of many serious birth defects and diseases. That’s why it’s so important to watch your baby. If parents have any concerns, they should consult an ophthalmologist as soon as possible. The ophthalmologist will be able to check visual acuity as well as the type and angle of strabismus. He can also assess the structure of the eyeballs and suggest which methods of treatment or exercises should be introduced.

Check: Non-surgical treatment of strabismus in children

What are the symptoms of strabismus in children?

Strabismus is not just a cosmetic defect. Its primary symptom is easily noticeable as usually the child’s eyes or eye run away towards the temple or nose. However, this is not the only symptom of strabismus. It may also be abnormal when the child is squinting his eyes, tilting his head, or turning one eye closed when the child is looking at something. Such symptoms are an indication for an ophthalmological consultation.

A child’s squint usually appears convergent, meaning that one or both of the child’s eyes point towards the nose. This form of strabismus occurs mainly in two- and three-year-olds. It is a common cause of hyperopia. The symptoms of strabismus are initially non-permanent, meaning they may appear from time to time. However, it may take a permanent form over time.

The symptom of divergent strabismus is the orientation of the eyeballs towards the temples. Initially, the strabismus does not need to be visible all the time. The eye escapes the child, e.g. when he thinks about something or looks at something.

Symptoms will also vary with oblique strabismus. It results from the paresis of the upper oblique muscle. Oblique strabismus can be acquired or congenital. This type of strabismus may be evidenced by, for example, unusual body positions, caused by a compensatory tilt of the head by a child. In this case, the child tilts its head towards the healthy eye, lowers its chin or turns its head towards that side.

Check: Methods of treating strabismus in children

How is strabismus diagnosed?

Early diagnosis of strabismus is very important for the effectiveness of the introduced treatment method. The earlier the disease is diagnosed, the greater the chances of successful treatment.

Usually, the doctor recognizes strabismus during a detailed medical interview collected from the parents, so it is worth monitoring your child closely and reacting when anything worries us. The ophthalmologist may also perform the following ophthalmological examinations as part of diagnostics:

  1. determination of visual acuity;
  2. viewing angle measurement;
  3. assessment of the position of the eyeballs;
  4. vision control in each eye.

Thanks to these tests, the doctor can not only diagnose strabismus, but also determine its type and determine the methods and subsequent stages of treatment. If necessary, the doctor may also order other additional tests or consultations with other specialists.

Early diagnosis and the decision to start treatment is of great importance, but its course. However, it should be remembered that the strabismus should not raise our concern only in newborns and children in the early stage of infancy. However, this state requires observation. If strabismus persists in infants at three months of age, it should be considered abnormal and requires consultation.

The diagnosis of strabismus may include:

  1. visual acuity test;
  2. corneal reflex tests;
  3. tests involving alternating covering and uncovering the eyes;
  4. study of eye movements;
  5. study of reflection and fixation of the eyes;
  6. examination of the anterior segment of the eye and the fundus;
  7. determination of the strabismus angle.

What is the surgical treatment of strabismus in children?

Surgical treatment of strabismus depends on the individual case. During the operation, the muscles responsible for the movements of the eyeball can be strengthened or weakened. The operation is performed under full anesthesia and under the supervision of an anesthesiologist. This procedure takes approximately 30 minutes.

Then, for the next 1-2 days, the patient is under observation in the hospital ward. The recovery period takes about 6 weeks.

Before a doctor can perform strabismus surgery, certain tests are necessary. Should do:

  1. morphology;
  2. blood sugar test – remember to do the test on an empty stomach;
  3. HCV testing;
  4. blood coagulation test;
  5. blood sodium and potassium tests.

Strabismus surgery is always performed on an empty stomach, which means that the patient can eat the last meal approx. 6 hours before the time of the planned surgery. It is important to follow your doctor’s instructions closely.

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