What is children’s strabismus?
Strabismus is a visual defect in which the eyes are not properly aligned with each other, meaning that each eye looks in a different direction.
In most cases, one eye is dominant and the other deviates, but there is also the possibility of alternation, in which both eyes can be seen to wander to the right or left.
There are different types of strabismus. Each has its particular clinical characteristics, onset age, prognosis and treatment.
Some strabismus cases may appear before the age of six months (congenital strabismus) and others years later, even in adulthood.
What causes it?
Strabismus can be caused by various factors. In ophthalmological terms, the first thing to consider is its possible association with a refractive error, e.g. myopia.
Since ocular alignment is controlled by the brain, any disorder affecting the central nervous system can lead to strabismus: a severe fever, an illness or even stress suffered by children as a result of changing schools or parental separation, etc.
How can it be prevented?
Strabismus cannot be prevented but can be detected early. The child’s parents are usually the first ones to notice the ocular deviation.
Strabismus often occurs intermittently, becoming more pronounced when the child is tired or in a weakened state, e.g. with a fever.
To correct strabismus properly, it is very important to detect the disorder before the age of seven.
Although the deviation can be corrected after this age, vision in the affected eye cannot be restored.
The most serious consequence of strabismus is amblyopia or lazy eye.
This occurs when the child’s brain suppresses vision in one eye to prevent double vision. The eye that is used less gradually becomes “lazy”.
Another consequence of strabismus is the loss of binocular vision, which is the ability to perceive depth, calculate distances and see in 3D.
As well as the physiological aspects of strabismus, consideration has to be given to the effect of the disorder on the self-image and self-esteem of children suffering from the symptoms.
The doctor should perform a comprehensive eye examination to assess the degree of deviation, ocular motility, refraction and fundus of the eye.
If a refractive error exists, it must be treated by optical correction (glasses or contact lenses). This is usually enough to cure strabismus. If amblyopia develops, it is necessary to restore vision in that eye, which is usually achieved by covering the healthy eye with a patch.
Eye surgery is only necessary if eye deviation persists after the optical defects and amblyopia have been corrected.
The amblyopic eye has not developed vision correctly, but all eye structures are in good condition. Vision develops from birth, and the eye becomes increasingly more capable of perceiving objects, which is called visual acuity. The amblyopic eye does not develop visual acuity for various reasons. The eye is anatomically correct, i.e. its structures are normal, but vision has not developed.
Ocular occlusion is used to make the diseased eye work harder by patching the healthy one, as in amblyopia. The intensity of the patching of the good eye to develop the vision of the amblyopic eye depends on the degree of vision and the age of the patient.
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