Strabismus (turned eyes)
Do not delay if  your child has strabismus. Seek professional advice from your family doctor for this is an important medical problem

The results of treatment are usually very good, but may depend on how quickly treatment is begun.
This applies particularly to very young children. If treatment is unduly delayed, vision may not be able to be restored. This type of blindness can be completely prevented.

Contents:                                                               Return to Eyetech Prof. Dev. Page
               What is Strabismus?                                  Return to Table of Contents
               What causes Strabismus?
               What are the effects of a turned eye?
               Importance of Strabismus
              Management of Strabismus
              Treatment
              Is your child especially at risk?
 
 
 
 
 

What is Strabismus?
Strabismus, the medical term used when the two eyes are not straight occurs in approximately 2% to 4% of the population.
There are three common types of strabismus:

1. Crossed eyes: a child may be born with this condition, or it may develop within a few  months of birth or between 2 and 4 years of age. This is also called esotropia, or convergent squint.


2. Divergent eyes: a child may be born with this condition, or it may develop later. This is also called exotropia, or divergent squint.


 
3. Vertical strabismus: the eyes are out of alignment vertically. Hypertropia.  Frequently these children present because they tilt their head to the side.
 

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What causes Strabismus?

         1. Genetic Predisposition: There is often an inherited  tendency in patients with strabismus.
        2. Poor focus:  Sometimes the condition is due to the need for glasses, particularly farsightedness.
        3. Abnormal muscle:  A muscle abnormality may cause an eye to turn. this is rare in children.
        4. Poor vision:  Strabismus may be secondary to loss of vision in an eye due to a serious problem, such as a cataract or tumour.
        5. Neurological or congenital problems (e.g. Cerebral Palsy or Downs Syndrome) are commonly associated with strabismus.
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What happens to sight if an Eye is turned?
Vision is lost in the turned eye because the brain cells driven by that eye are not being used. This is referred to as AMBLYOPIA or Lazy Eye.
        One such circumstance is if a child is born with straight eyes, but one eye turns in at about the
        age  of 2 years. If this condition is not treated urgently, vision may be reduced to partial sight
        (legal blindness) in the turned eye. If treatment is begun immediately, however, perfect
        vision can often be restored.

        Another situation where loss of vision may occur is when the eyes are unequally focused.
        If one eye is out of focus with the other, the brain may ignore the image from the eye
        improperly focused. This prevents development of normal vision in the affected
        eye. This condition is also called AMBLYOPIA or Lazy Eye.

        Defective binocular vision: the eyes need to be straight for fusion in the brain of the
        images of the two eyes. This gives accurate vision and stereopsis, or 3-D vision; 3-D
        vision is one of the ways used to judge depth.
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Importance of Strabismus
         1. Loss of vision in turned eye.
       2. The eye may be turned because of poor vision caused by a tumour in the eye, a cataract or even a brain tumour.
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Management of Strabismus
Before any treatment is commenced it is important to know why the eye is turning. Your Doctor must:
 1. Establish a cause for the squint: and answer the following  questions:
             a. Is there a focusing problem?
             b. Are the eye muscles normal?
             c. Is there a problem in the eye or brain which could be the cause?
2.Advise what is the aim of treatment:
           a. Achieve good vision in each eye.
           b. Restore stereopsis i.e. binocular vision.
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Treatment
This follows a full assessment which will exclude eye problems and serious causes of Strabismus.
a. Prescription of spectacles- (if needed) may straighten the eye. This may be the only treatment required.

b. Treat Amblyopia- Usually a patch is required. sometimes drops are prescribed. This is continued until the vision has improved to its maximum level. This does not straighten the eye.

c. Surgery: Adjustment of the eye muscles may be necessary. This is very good surgery but not perfect surgery. 80-90% of patients' eyes will be straight after one operation. Of course this means one in ten may need more than one operation.

The results of treatment are usually very good, but may depend on how quickly treatment is begun.
This applies particularly to very young children. If treatment is unduly delayed, vision may not be able to be restored.

This type of legal blindness can be completely prevented.
Do not delay if  your child has strabismus. Seek professional advice from your family doctor for this is an important medical problem.

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Is your child especially at risk?
If any members of your family have had strabismus, there is an increased risk that a squint may develop in your child. Therefore even if the eyes appear to be straight, the child should be examined by an ophthalmologist- a medically qualified eye specialist-by the age of 1 year.
Remember-  It is possible to examine a child of any age for strabismus and determine whether the eyes are properly focused. If you are not sure whether your child's eyes are straight, consult your family doctor, who may advise a referral to a medical eye specialist..
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