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Strabismus

What Is Strabismus?

Strabismus is a visual problem in which the eyes are not aligned properly and point in different directions. One eye may look straight ahead, while the other eye turns inward, outward, upward, or downward. The eye turn may be consistent, or it may come and go. Which eye is straight (and which is misaligned) may switch or alternate.
Strabismus is a common condition among children.

There are several types of strabismus but the most comon are:

Infantile esotropia, where the eye turns inward, is a common type of strabismus in infants. Young children with esotropia cannot use their eyes together.

Accommodative esotropia is the most common form of esotropia that occurs in children usually 2 years or older. In this type of strabismus, when the child focuses the eyes to see clearly, the eyes turn inward. This crossing may occur when focusing at a distance, up close or both.

Exotropia, or an outward-turning eye, is another common type of strabismus. This occurs most often when a child is focusing on distant objects. The exotropia may occur only from time to time, particularly when a child is daydreaming, ill or tired. Parents often notice that the child squints one eye in bright sunlight.

 
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What is strabismic amblyopia?

Good vision develops during childhood when both eyes have normal alignment. Strabismus may cause reduced vision, or amblyopia, in the misaligned eye.

The brain will pay attention to the image of the straight eye and ignore the image of the crossed eye. If the same eye is consistently ignored during early childhood, this misaligned eye may fail to develop good vision, or may even lose vision. Strabismic amblyopia occurs in approximately half of the children who have strabismus.


Amblyopia treatment

Treatment for amblyopia involves forcing the brain to pay attention to the images of the amblyopic or weaker eye so that vision in that eye gets stronger. This is done through glasses, eye patches, eye drops, surgery, or a combination of these:

- Glasses. Glasses are prescribed when amblyopia is caused by severe refractive errors and/or anisometropia (when one eye sees more clearly than the other). Glasses help send clear, focused images to the brain, which will teach it to "switch on" the weaker eye. This allows the brain to use the eyes together and develop normal vision.

- Eye patches. In many cases, kids with amblyopia must wear an opaque eye patch over their stronger or unaffected eye. The patch is worn for 2-6 hours a day while the child is awake for several months or years, depending on the severity of the condition. There are two types of eye patches: the first type works like a band-aid and is placed directly over the eye. The second type, designed specifically for kids who wear glasses, is a cloth patch that fits securely over one lens.

- Surgery. If strabismus is the cause of a child's amblyopia and treatment with glasses, patches, or drops doesn't improve the alignment of the eyes, eye muscle surgery might be an option. Surgery involves loosening or tightening the muscles that are causing the eye to wander. Although it is an invasive measure, surgery is considered safe and effective and usually does not require an overnight hospital stay.


How to spot first signs in your child?

Carefully observing your child you may see the following:
  • The head of a child is permanently crooked.
  • On the trips or walks does not recognize the things you point. Most likely is shortsighted.
  • While drawing has a close distance to the paper. In this case the child is most likely shortsighted.
  • When watching TV, the distance to it gets shorter.
  • Often complains of headaches, especially after playing with small objects, doing puzzles or watching a picture book.
  • The eyes are red and watery. Cannot stand the light, blinking often and rubs the eyes.

If you notice any of the above symptoms you should visit the ophthalmologist to clarify the situation and, if necessary, take appropriate treatment.