WHAT IS STRABISMUS?
Strabismus is a disorder in which both eyes do not line up in the same direction. Therefore, they do not look at the same object at the same time. Six different muscles surround each eye and work "as a team." This allows both eyes to focus on the same object. In someone with strabismus, these muscles do not work together. As a result, one eye looks at one object, while the other eye turns in a different direction to focus on another object. When this occurs, two different images are sent to the brain -- one from each eye. This confuses the brain. In children, the brain may learn to ignore (suppress) the image from the weaker eye. If the strabismus is not treated, the eye that the brain ignores will never see well. This loss of vision is called amblyopia. Another name for amblyopia is "lazy eye." Sometimes lazy eye is present first, and it causes strabismus. In most children with strabismus, the cause is unknown. In more than half of these cases, the problem is present at or shortly after birth. This is called congenital strabismus. Most of the time, the problem has to do with muscle control, and not with muscle strength.
SYMPTOMS : Symptoms of strabismus may be present all the time, or may come and go. Symptoms can include: Crossed eyes Double vision Eyes that do not aim in the same direction Uncoordinated eye movements (eyes do not move together) Loss of vision or depth perception. It is important to note that children may never be aware of double vision. This is because amblyopia can develop quickly.
TREATMENT : Treatment has been expanded. The first step in treating strabismus in children is to prescribe glasses, if needed. Next, amblyopia or lazy eye must be treated. A patch is placed over the better eye. This forces the weaker eye to work harder and get better vision. Your child may not like wearing a patch or eyeglasses. A patch forces the child to see through the weaker eye at first. However, it is very important to use the patch or eyeglasses as directed. Eye muscle surgery may be needed if the eyes still do not move correctly. Different muscles in the eye will be made stronger or weaker. Eye muscle repair surgery does not fix the poor vision of a lazy eye. Muscle surgery will fail if amblyopia has not been treated. A child may still have to wear glasses after surgery. Surgery is more often successful if done when the child is younger. Adults with mild strabismus that comes and goes may do well with glasses. Eye muscle exercises may help keep the eyes straight. More severe forms will require surgery to straighten the eyes. If strabismus has occurred because of vision loss, the vision loss will need to be corrected before strabismus surgery can be successful.
Op.Dr.Ahmet UMAY Bristol University Ophtalmology Section United Kingdom References : Strabismus. American Association for Pediatric Ophthalmology and Strabismus. www.aapos.org/terms/conditions/
