What is strabismus (crossed eyes) and how does it affect you?
The condition strabismus (crossed eyes) occurs when the eyes do not line up with one another. In other words, one eye is directed in a different direction from the other.
The six muscles that regulate eye movement normally function together to point both eyes in the same direction. Patients with strabismus have difficulty controlling their eye movement and maintaining appropriate ocular alignment (eye position).
The direction of the twisted or misaligned eye can be used to classify strabismus:
- Turning inward (esotropia)
- Turning outward (exotropia)
- Turning upward (hypertropia)
- Turning in the opposite direction (hypotropia)
Other considerations for determining the origin and therapy of strabismus include:
Is the problem new or has it been present for some time?
Was it present during the first six months of life or did it develop later?
Is it always the same eye, or does it alternate between them?
Is there a minor, moderate, or significant degree of turning?
Is it present all of the time or only some of the time?
Several types of strabismus exist. The following are the two most common:
Accommodative esotropia is a type of accommodative esotropia that happens when a person has uncorrected farsightedness and a hereditary inclination (family history) to turn their eyes inward. The extra focusing effort required to maintain distant items in clear focus may cause the eyes to tilt inward since the ability to focus is linked to where the eyes are pointing. Double vision, closing or covering one eye when gazing at something close, and tilting or twisting the head are all symptoms. The onset of this type of strabismus is usually in the first few years of life. Glasses are commonly used to cure this problem, although it may also necessitate eye patching and/or surgery on the muscles of one or both eyes.
Intermittent exotropia: One eye will fixate (focus) on an object while the other eye is gazing outward in this type of strabismus. Double vision, headaches, difficulties reading, eyestrain, and closing one eye when seeing far distant objects or in strong light are all possible symptoms. Patients may experience no symptoms, but others may perceive the ocular deviation (difference). Exotropia that occurs on a regular basis can occur at any age. Glasses, patching, eye exercises, and/or surgery on the muscles of one or both eyes may be used to treat the condition.
What are the causes of strabismus?
The majority of strabismus is caused by a problem with the neuromuscular control of eye movement. Our knowledge of the brain's control centers is still developing. A issue with the actual eye muscle occurs less frequently. Strabismus is frequently inherited, with roughly 30% of children with the condition having a family relative with the same condition.
The following conditions are linked to strabismus:
Refractive defects that haven't been fixed
One eye has a vision problem.
Cerebral palsy is a condition that affects the brain.
Down syndrome is a condition in which a person (20-60 percent of these patients are affected)
Hydrocephalus is a condition in which a person's (a congenital disease that results in a buildup of fluid in the brain)
Tumors of the brain
a stoke (the leading cause of strabismus in adults)
Head injuries can harm the part of the brain that controls eye movement, as well as the nerves that regulate it and the muscles that govern it.
Problems with the nervous system (nervous system)
Graves' disease is a chronic illness that affects people (overproduction of thyroid hormone)
When do strabismus symptoms show up?
An infant's eyes should be able to focus on small objects and be straight and well-aligned by the age of 3 to 4 months. A 6-month-old baby should be able to focus on both close and remote objects.
Strabismus is most common in infants and young children, with the majority of cases occurring by the age of three. Strabismus can, however, affect older children and even adults. In an older child or adult, the abrupt occurrence of strabismus, especially with double vision, could suggest a more serious neurologic condition. If this occurs, contact your doctor right away.
Pseudostrabismus (false strabismus) is a condition in which a baby's eyes appear to be crossed when they are actually pointing in the same direction. Extra skin covering the inner corners of the eyes and/or a flat nasal bridge can induce pseudostrabismus. The eyes will no longer appear crossed as the baby's face matures and grows.
What are the symptoms of strabismus and how can you know whether you have it?
Anyone over the age of four months who looks to have strabismus should see a pediatric ophthalmologist for a full eye exam, with extra time spent looking at how the eyes focus and move. The following items may be included in the examination:
Patient's medical history (to determine the symptoms the patient is having, family history, general health problems, medications being used and any other possible causes of symptoms)
Visual acuity (reading letters from an eye chart or observing the visual behavior of young infants)
Refraction is a term used to describe how light (checking the eyes with a series of corrective lenses to measure how they focus light). When checking for glasses, children do not need to be old enough to give verbal input.
Tests of alignment and attention
After dilatation (widening) of the pupils, an examination is performed to determine the health of the internal ocular components.
What is the treatment for strabismus?
The following are some treatment options:
Patients with uncorrected refractive problems should use eyeglasses or contact lenses. Corrective lenses need less focusing effort and allow the eyes to remain straight.
Prism lenses are special lenses that help lessen the amount of turning the eye must make to look at objects by bending light entering the eye.
Orthoptics (eye exercises): Orthoptics can help with various types of strabismus, particularly convergence insufficiency (a form of exotropia).
Eye drops or ointments are used as medications. Botulinum toxin type A (Botox) injections can also weaken an overactive eye muscle. Depending on the patient's situation, these treatments may be utilized in conjunction with or instead of surgery.
Patching is used to cure amblyopia (lazy eye) in patients who have both strabismus and amblyopia. The regulation of eye misalignment may improve as vision improves.
Eye muscle surgery corrects the alignment of the eyes by altering the length or position of the eye muscles. This is done using dissolvable stitches under general anesthesia. Adjustable strabismus surgery, in which the eye muscle locations are altered after surgery, is sometimes offered to adults.