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Strabismus is a vision defect that affects the eye’s ability to coordinate movements when focusing on objects. Offering two asymmetrical views, imperfectly aligned eyes often cause faulty depth perception and are associated with disorders like crossed eyes, squint, walleye, and heterotropia. Without proper strabismus treatment, these conditions can worsen, and certain aspects of vision may be permanently affected.

Strabismus Causes

Strabismus differes from refractive errors such as myopia, hyperopia, and astigmatism. In some cases, the inability of the eyes to focus symmetrically can be attributed to problems with the muscles controlling eye movement. More commonly, however, strabismus results from problems in the brain. The brain may have trouble fusing the two images it receives from the eyes and in rare cases a tumor may be affecting its ability to process visual information. Often, children experience strabismus as a result of problems that can be easily treated with glasses. There is also evidence that the condition may be hereditary.

Strabismus Symptoms

The different types of strabismus produce a variety of symptoms. Depending on which way the misaligned eye or eyes are oriented, people suffering from this disorder may have difficulty focusing on objects or judging distances, or they may experience double or blurred vision. Detecting symptoms is the first step in determining whether strabismus treatment such as surgery is advisable. Perhaps the most obvious symptom is crossed eyes, or a single eye that visibly tilts to the left, the right, up, or down and is unable to coordinate movements with its partner. Squinting in children may also be a sign of this condition.

Strabismus Types

Depending on how vision is disrupted, strabismus can take several different forms. Once doctors have accurately diagnosed which form is involved, the best strabismus treatment plan can be determined. If the affected eye or eyes always display an inability to properly coordinate movements, the condition is known as constant strabismus. If problems only occur episodically, it is considered intermittent. Another disorder, esotropia, occurs when both eyes turn inward, resulting in crossed eyes.

If the eye turning is oriented outward rather than inward, the disorder is known as exotropia. Children who experience this condition often appear to be daydreaming or not paying attention. Yet another type of strabismus is hypertropia, in which symmetrical vision is inhibited by an excessive orientation upward of one or both eyes. Finally, a complicated condition known as Duane’s Syndrome affects the eye’s capacity to make normal lateral movements away from and toward the nose. Here, the problem isn’t that an eye is abnormally tilted but rather that it fails to rotate sufficiently when the gaze shifts to the right or left.

Strabismus Diagnosis

Diagnosis of strabismus should occur as early as possible and certainly before a child reaches the age of two. It is advisable that all children receive a checkup when they are between six and nine months old, and ideally never later than one year of age. Beyond two years, strabismus treatment becomes difficult, and even ambitious strabismus surgery often proves ineffective. In addition to carefully looking for visible signs like wayward, crossed, or diverging eyes, doctors will consider a child’s medical history when trying to determine whether an eye disease, uncorrected vision, or another condition is causing symptoms.

Conditions Associated with Strabismus

One result of strabismus is double vision, which occurs when two uncoordinated eyes fail to focus on the same object. As a result of this inability, two separate, slightly out-of-kilter views of the world are relayed to the brain, causing patients to see everything twice. However, while double vision is often directly caused by strabismus, it may have other origins. Its presence therefore doesn’t necessarily call for strabismus treatment. In the same way, many symptoms that initially suggest the presence of this condition – like diverging, misaligned, or converging eyes – may also signal unrelated conditions requiring their own special course of treatment. Any thorough diagnosis will entail ruling out conditions often mistaken for strabismus including amblyopia (lazy eye), cataracts, esophoria, exophoria, and Graves' disease.

Strabismus Treatment

Strabismus treatment ranges from being as simple as correcting children’s eyesight with glasses and relatively simple vision therapy to more complex strabismus surgery. Intermittent strabismus, for example, can usually be handled effectively with eye patches, special glasses, and vision therapy. Over time, such basic treatment normally allows the brain to gain control over eye movements, and surgery is not required. In cases of constant strabismus among children, the surgical option may be recommended; however, since there is no guarantee it will actually improve vision, this is usually considered a last resort.

Talk to a Strabismus Specialist in Your Area

If your child is experiencing symptoms of strabismus, you should speak to a qualified specialist as soon as possible. Without appropriate strabismus treatment, the condition can deteriorate and children may develop long-term problems that are difficult or impossible to resolve. Use DocShop to locate an area ophthalmologist specializing in strabismus today.

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