Strabismus occurs when the axes of the eyeball are not parallel to each other so that the eyes (one or both) are deviated either towards the nose (convergent strabismus) or towards the ear (divergent strabismus).
Most often it occurs in childhood, it is also called “crossed-eyes”. Children who have strabismus can easily be diagnosed only by simply observing the position of the eyeball. Strabismus can occur in the first months after birth (congenital) or around the age of 3 years (due to hypermetropia = shorter eye). Strabismus may also be due to other causes such as cataracts, the presence of an ocular tumor (retinoblastoma). In these cases, surgical treatment should be done urgently.
Children with strabismus can complain of the following symptoms: blurred vision, eye fatigue, sensitivity to strong light, double vision (this usually occurs at the onset of strabismus).
During the ophthalmologic examination, the doctor looks at: which of the eyes is affected (or if both eyes are affected), the direction in which the eye is deflected, when the abnormal deviation occurs (it is permanent or occurs only when the child looks in a certain direction).
Learn how strabismus is treated
Treatment of strabismus should be started as soon as possible, from the moment of diagnosis. The treatment is individualized according to the child’s age. Under the age 1 year, drops of atropine are prescribed, intermittently in the two eyes, to maintain an equal view of the two eyes. After the age of 1 year, the child can wear glasses. Parents should be advised that in the case of hypermetropia, it should be corrected from childhood by prescribing glasses. Some children need special lenses with prisms or bifocal lenses. If the child has a difference in diopters between the two eyes ( anisometropia ) and the visual defect is not corrected in time, it will lead to lower eye vision with greater defect (the brain tends to favor the “good” eye and will only rely on it over time). This condition is called amblyopia or “lazy eye” and is treatable only in the early years of childhood, when progressive development of the visual system occurs. After final visual maturation (around the age of eight or nine years), amblyopia can no longer be treated. First amblyopia treatment is occlusion of the good eye in order to force the child to use the weaker eye.
It should be highlighted that the measurement of refraction vices in children is done only with special droplets, which have the role of temporarily paralyzing the muscles of the accommodation. Without droplets, the measurements are of no value, as they indicate false diopter values (as children have a very large accommodation capacity)
Surgery is often the only one able to align eyeballs and to improve eyesight with strabismus by weakening or strengthening the muscles responsible for eye deflection. After surgery, he will continue to wear the glasses recommended prior to surgery.
Analyses, complications and recommendations
Complications (fortunatelly very rare):
- inefficiency of the surgery
- red eye
- vicious scarring
- double sight (diplopia)
- exposure to dust, wind is forbidden
- swimming is forbidden (pool, lake, sea) for 30 days
- during the first 2 weeks after surgery it is recommended to get help when washing your head to avoid water entering the eye
- eye make up is forbidden for 3 weeks
- rubbing your eyes is forbidden(it must be avoided for 1 month)
- local trauma, intense physical efforts are forbidden, especially in the first 6-8 months
Mandatory post operative checks are: the first day after surgery, after 6 weeks, 6 months, and then once a year. Depending on the case, these dates may be subject to change.
The patient is informed during the preoperative consultation about complications, risks, results..
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