Children with strabismus have one eye looking forward and the other eye looking oblique. This can happen at any age.
The strabismic eye may be slanted inward or outward, or it may be slanted vertically, meaning that one eye is higher than the other. Strabismus can be chronic or intermittent, and in some cases, depending on the situation, such as when the child looks close to a book, when tired, or when looking at a distance. A chronically strabismic eye can occur in three situations.
1, Long-term strabismus in the eye, due to lack of use resulting in delayed visual development is called amblyopia.
2. Low vision in both eyes
The ability to see in depth and stereo requires both eyes to be used in parallel, so a child with long-term strabismus will lack depth and stereo vision.
3. Abnormal head position
In order to make both eyes work together, some children with long-term strabismus will tilt their head or face.
Causes of strabismus in children
1. Abnormal visual development in both eyes.
2.Malfunction of the nerve that governs eye movements.
3. Development of the extraocular muscles themselves.
Treatment of strabismus in children can be divided into two steps.
1. Amblyopia problems must be treated first. The normal eye will be blindfolded, forcing the child to use the eye with z amblyopia. When vision returns to normal in that eye, the child will use both eyes at the same time and both eyes will alternate with strabismus.
2. When the strabismic eye regains normal vision, surgery must be performed to restore both eyes to their normal position. The child will only regain binocular vision during childhood. After that, the vision cannot be normalized.
When should surgery be performed?
Children with long term strabismus should have surgery as soon as vision returns to normal in both eyes in order to normalize vision in both eyes. If the strabismus is intermittent, surgery is not necessary because the child sometimes still has the ability to see with both eyes. In adults, if the strabismus has been present for a long time and the patient is no longer able to see monocularly, surgery can only improve the appearance of the eye.
Strabismus and glasses
Uncorrected myopia or hyperopia can also cause strabismus. Glasses can sometimes reduce or completely correct the strabismus without surgery. Therefore, all children with strabismus should have an eye exam. If glasses are needed, they must be worn at all times to help improve the eye position.
If glasses do not correct the strabismus, surgery may be required.
Pseudostrabismus
Many infants have what appears to be an internal strabismus because the eyelids cover the inward part of the eye. This appearance is called pseudostrabismus and does not require any treatment.
Misconceptions about strabismus
Misconception: “Children under two years old cannot be tested.”
Fact: Any child, no matter how young, can be tested for strabismus. If detected early, strabismus can be treated promptly.
Misconception: “Strabismus does not need to be treated, it will stop when the child is older.”
Fact: If strabismus is ignored, amblyopia will develop. The child’s vision may be damaged for a long time.
Misconception: “Strabismus does not need to be corrected if it is not severe.”
Fact: A mild strabismus can cause amblyopia or impaired binocular vision just as much as a severe strabismus. Children should be examined and treated by an eye doctor as soon as possible.
Misconception: “Strabismus can be corrected at any age.”
Fact: While the surgery in question can be performed at any time, it can only improve the appearance after the effective period. Early surgery (after appropriate amblyopia treatment) can restore binocular vision and coordination.
Misconception: “After surgery, the child will not need glasses.”
Fact: Surgery only adjusts the eye position but does not correct the visual problems caused by incorrect prescriptions.
The importance of early treatment
Children with amblyopia who do not receive treatment will have long-term visual impairment. Children with long-term strabismus also do not have balanced vision in both eyes.
Early treatment of amblyopia and strabismus surgery can restore normal binocular vision to the child.