STRABISM children and adults
At the Optisan Clinic, strabismus treatment is done with the help of vision therapy:
– without surgery in low-grade strabismus
– pre-operative and post-operative in high grade strabismus
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WHAT IS STRABISMUS?
Strabismus
is a common ophthalmological condition that manifests itself by the deviation of one or both eyes from the central visual axis.
Strabismus is both an aesthetic problem and a binocular vision disorder and a possible cause of amblyopia. The straight looking eye becomes dominant and the deviated eye no longer transmits the correct image to the brain. This can lead to amblyopia (lazy eye disease). Read more about amblyopia here.
CAUZE
- Heredity – especially heredity of refractive errors (myopia, hyperopia, astigmatism) – in 60 to 80% of cases;
- Nervous system disorders: neonatal neurological history – prematurity, dysmaturity, cerebral palsy, meningitis;
- Head trauma, orbital trauma;
- Refractive vision, refractive differences between eyes;
- Hyperopia is frequently associated with convergent squint;
- Congenital changes of the orbital bones;
- Unilateral ptosis (drooping eyelid);
- Unilateral congenital cataract;
- Unknown cause – very often we don’t find a cause of strabismus.
TYPES OF STRABISMUS
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The most common types of strabismus:
- Congenital esotropia is common. It is a convergent strabismus that appears in the first months of life. Treatment is almost exclusively surgical, often requiring more than one operation due to the complexity of this squint.
- Accommodative esotropia, the deviation of the eyes towards the nose, is a convergent strabismus that often occurs after the age of 2. It is accompanied by refractive errors, most commonly hyperopia, and is caused by the accommodation effort the child makes to see clearly, which causes the eyes to deviate towards the nose. This deviation can occur when the child looks at a distance or at close range or both. Glasses reduce accommodation effort and correct eye position. If the deviation is not significantly reduced during the wearing of the optical correction, it is advisable to start a visual therapy protocol that will aim to align the eyes.
- Exotropia, outward deviation of the eyes, is another common type of strabismus. This deviation occurs most often when the child is looking at a distance. Exotropia may only be present at certain times of the day when the child is tired or inattentive. Parents often only notice the deviation in bright light. Exotropia also requires early intervention with visual therapy protocols, but in many cases also requires surgical treatment.
STRABISMUS IN ADULTS
The majority of adult strabismus are residual strabismus (operated on but not fully corrected) or consecutive strabismus (strabismus that was originally of a certain type but after surgery/operations changed its appearance – i.e. the patient had surgery for convergent strabismus and over time, relapsed into divergent strabismus). There are also strabismus that begin in adulthood with various causes and that result in DIPLOPIA (double vision). Adults do not have the ability to ignore one of the images if they previously had normal binocular vision. That’s why they close one eye or look for a compensatory position (torticollis) in which they manage to superimpose the images.
As a rule, in old strabismus, patients do not have diplopia because there has been time for the brain to adapt to the situation. However, it may occur postoperatively after alignment of the visual axes.
When a patient goes to an ophthalmologist because they are seeing double and it is an acquired squint, they have every chance of having their problem solved.
There is a misconception that strabismus is difficult or impossible to treat in adults.
In reality, adults have treatment options:
- prism glasses – in minimal deviations – have no effect in large deviations.
- Computerised visual therapy
- surgical treatment.
- botulinum toxin – used mainly in extraocular muscle palsies, but also in multiple strabismus with an unsatisfactory result, in case of small or intermittent deviations.
SIGNS AND SYMPTOMS
Strabismus, commonly called cross-eye, is the inability of one or both eyes to focus on the same point in space. Specifically, both eyes cannot look in the same place at the same time.
- The eyes don’t move together.
- Eyes do not look aligned.
- The child blinks frequently, especially in bright light.
- The child watches with half-closed eyes.
- Double vision;
- The child keeps his head turned to one side, especially during close-up activities.
IMPORTANT TO KNOW FOR PATIENTS DIAGNOSED WITH STRABISMUS
Diagnosed patients should be aware that strabismus does not go away by itself and, over time, the deviated eye can develop amblyopia.
Specialist treatment is needed and is decided following an ophthalmological consultation.
The earlier it is diagnosed, the greater the chance of vision improvement.
TREATMENT OF STRABISMUS
Treating strabismus starts with prescribing glasses.
In most cases of strabismus, before surgery, treatment is done by non-invasive methods such as vision therapy, prescription of prismatic lenses, etc..
If these treatments do not work and the eye deviation is not corrected, the patient will undergo surgery.
However, surgery only solves the problem of deviated eyeballs, aligns them, but will not improve vision, while vision therapy can help develop vision. That’s why it’s important for patients to know that after surgery they must follow visual therapy protocols to improve their vision and eliminate diplopia (double vision).
This is now possible in Romania. At the Optisan eye clinic, vision therapy is successfully used to treat strabismus without surgery (low-grade strabismus) and pre-operatively and post-operatively for high-grade strabismus.
HOW THE MEETINGS GO
OF VISUAL THERAPY?
After the ophthalmologist establishes the treatment protocol, the vision therapy sessions are carried out both in the clinic and at home, with specialist monitoring.
Visual therapy sessions in the clinic are conducted under the guidance and supervision of the therapist. During each session, the specialist adjusts all techniques according to the patient’s needs.
As regards home vision therapy, each patient will receive the information and explanations necessary for their proper conduct, and progress will be monitored by the therapist.
WHAT PATIENTS WHO HAVE TRIED TREATMENT AT THE OPTISAN CLINIC SAY
More patient experiences can be read/read here.
Diagnosed with amblyopia or strabismus? Have you been told that nothing more can be done? You want to try vision therapy but don't know what your chances of recovery are.
Make an appointment with the Optisan Clinic specialists for a consultation and initial investigations.