1.What is strabismus? How can strabismus be detected early? A: Strabismus refers to when looking at a target, one eye looks at the target, the other eye deviates from the target, manifested as the position of the two eyes is not symmetrical. What we usually call “crossed eyes” is internal strabismus, and what is commonly called “window pushing eyes” is exotropia. If one of the following conditions occurs, there is a possibility of strabismus, and you should go to the hospital for a specialist examination in time: parents find out if the child has strabismus when he/she is inattentive or his/her whole body resistance decreases; he/she has the habit of looking at things with a crooked head; he/she is easily afraid of bright light and often squinting one eye to see things. 2.What are the hazards of strabismus? A: The harm of strabismus can be said from three aspects, such as appearance, visual function and psychology, among which the impact on visual function is the most serious. First of all, the appearance is not beautiful, resulting in children’s psychological inferiority complex; secondly, the impact on the visual function, which makes the visual development more affected, the visual acuity of the strabismic eye is often poor, often causing severe amblyopia, strabismus patients generally do not have a normal sense of stereo; again, some strabismus if not treated in time will also affect the physical development of children such as facial asymmetry, crooked neck, etc. 3.How should strabismus be treated? When is the best age for strabismus surgery for children? A: The treatment of strabismus should be done as early as possible. The sensitive period of visual development is from birth to eight weeks old, of which the period from birth to three weeks old is the critical period; the maturity of visual acuity and visual function is generally before six weeks old. Strabismus that occurs during these times can seriously affect the development of visual acuity and visual function. When strabismus is treated after the sensitive period of visual development, the affected vision and visual function cannot be restored. Currently, the main treatment options include surgery and non-surgery. Most strabismus can be corrected only through surgery. Some children with internal strabismus can be treated with glasses to partially or completely eliminate the strabismus, and some children with small strabismus can be treated with trigeminal lenses or by training monocular function in both eyes to re-establish binocular vision. The timing of surgery depends on the type of strabismus, the condition of both eyes, and the time of onset: for strabismus caused by congenital mechanical factors, the earlier the surgery, the better if it is a ligament or myofascial abnormality. Most scholars of congenital strabismus believe that surgery within the first 6-18 months of life is best for establishing binocular vision. For strabismus with monocular strabismus or amblyopia, surgery is not urgent. The amblyopia should be treated first and surgery should be performed only after the vision of both eyes is balanced. Children with small degrees of strabismus, intermittent strabismus and unstable strabismus should be closely observed for changes in the pattern of strabismus, and there is no need to rush to surgery. For late onset strabismus, such as those occurring after the age of 2, surgery should be performed between the ages of 3 and 6. 4.What is amblyopia? What are the dangers of amblyopia? A: Amblyopia refers to the lack of obvious organic lesions in the eye, mainly caused by functional factors, the lower limit of normal visual acuity reference value of corrected 3-year-old children is 0.5, 4-5 years old is 0.6, 6-7 years old is 0.7, more than 7 years old is 0.8. The difference between the best corrected visual acuity of the two eyes is two lines or more, and the worse one is amblyopia. Amblyopia is a common disease in the development of children, with an incidence of about 3%. If amblyopic children are not detected and treated early, the greatest danger to the children is that they not only have low vision in both eyes or one eye, but also do not have perfect binocular vision. Amblyopia is more dangerous than myopia because in simple myopia, vision returns to normal after wearing glasses. Amblyopia, on the other hand, is different because the patient’s visual cells and nerves do not develop normally because they are not accurately stimulated by external objects for a long time. After correction with glasses, the vision is still lower than normal, and if not treated in time, the patient’s vision will be permanently low. Children with amblyopia not only have low vision, but also lack stereopsis, so they cannot accurately determine the orientation, position, and distance of objects. When they grow up, they are unable to perform a variety of occupations and jobs, such as architecture, engineering, medicine, mechanics, art and other professions. In addition, amblyopia combined with strabismus will affect aesthetics and physical and mental health. Children with amblyopia often have low self-esteem and autism. 5. Early detection and treatment of strabismus and amblyopia is very important. How should parents find out early whether their children have strabismus and amblyopia? Because strabismus has an obvious appearance, parents are able to detect it and bring their children to the hospital for treatment. Amblyopia, on the other hand, has a somewhat insidious onset. What methods are available for early detection? The primary method is early visual acuity testing. This is generally available at all kindergartens and is a very important screening and key method to determine the presence of amblyopia. For children who do not know how to check their vision, parents need to pay attention to their children’s movements at home. For example, whether the child’s posture is normal when using his eyes, whether his eyes squint, tilt his neck, or tilt his head, these are some important signs. Pay further attention to whether he has some kind of defect or visual impairment, and go to the hospital for examination after timely detection. In addition, parents should pay special attention to try to cover one eye of the child and pay attention to how the other eye behaves when looking at things. Another important method for early detection of amblyopia is optometry. Optometry provides an accurate picture of the refractive state of the child’s eyes. Families who are able to do so are encouraged to take their children to the hospital for a comprehensive eye exam. We hope that through the joint efforts of parents and doctors, we can detect children’s visual problems as early as possible and treat them early so as not to leave regrets in their lives. 6.Can amblyopia be cured? How should it be treated? The effect of amblyopia treatment is closely related to age, the younger the age, the better the effect. In addition, amblyopia treatment is closely related to the nature and degree of amblyopia and the nature of gaze. Therefore, early detection and timely and reasonable treatment are extremely important, and there is basically no hope for cure in adulthood. However, for those children and adolescents with amblyopia who are diagnosed late, they should not give up treatment easily, as active treatment will also yield certain results. For example, if the amblyopia is caused by congenital cataract or ptosis, the cataract must be removed surgically or the ptosis must be corrected; if the amblyopia is caused by strabismus, it must be corrected by surgery or glasses depending on the strabismus; if the amblyopia is caused by refractive abnormalities, it must be corrected by wearing Refractive amblyopia caused by refractive abnormalities must first wear moderate glasses to correct refractive abnormalities, so that light can be correctly focused on the retina and stimulate the development of vision. (a), wear glasses to correct refractive error: amblyopia is accompanied by refractive error, so the examination of amblyopia must be dilated pupil optometry, the purpose is to accurately test the actual refractive error, in order to match the appropriate glasses. The only way to improve visual acuity is to wear glasses to correct refractive errors and to conduct amblyopia training at the same time, so that clear images repeatedly stimulate the retinal gaze center and improve visual sensitivity, so the treatment of amblyopia must wear glasses. Because children’s eyes are developing, they should be examined once every six months to once a year. The number of glasses should be adjusted according to age, refractive status, strabismus and changes in corrected visual acuity. Accurate optometry and appropriate glasses play a key role in the treatment of strabismus and amblyopia. (2) Common methods of amblyopia treatment: (1) Covering therapy: Covering therapy is an ancient and effective amblyopia treatment method, which is one of the simplest, most economical and effective methods for treating children with amblyopia. Depending on the child’s condition, monocular masking and alternate masking of both eyes can be used. (2) Fine vision training: It is a special application exercise for amblyopic eyes, which is beneficial for visual development and improving visual acuity. There are many methods of fine vision training, which should be chosen according to the age, intelligence and vision of the amblyopic child, and the training method can be changed frequently, for example, using silk thread to thread a stitch, and the size of the stitch can be decided according to the vision. Embroidery, tracing, painting, calligraphy, etc. can also be practiced. Fine visual acuity training must be done with the amblyopic eye once a day for 10 to 15 minutes. Fine visual acuity training is an important part of successful amblyopia treatment for children, so parents should pay attention to this easy-to-use training and keep it up. (3) Visual stimulation therapy: various amblyopia treatment devices are used. Such as pulsed red light therapy, rear image lamp, the same vision machine training, visual energy enhancement signal stimulation and computer disc training, etc. (4) Comprehensive therapy: Since the mechanisms of various therapies are different, comprehensive therapy is superior to single therapy. In children with amblyopia of one eye, the first step is to routinely cover the healthy eye and give the amblyopic eye more gaze exercises, together with fine visual training and pulsed red light stimulation. Amblyopia with eccentric gaze can choose the posterior image method, etc. If the visual acuity of the amblyopic eye improves after several months of treatment, the child can go to the hospital for treatment with the same vision machine. It is worth noting that the treatment and training of amblyopia cannot be achieved overnight, but often takes several months, half a year or even several years, so the cooperation of the child and the patience and supervision of the parents are very important during the treatment and correction.