Strabismus, as the name implies, is a misalignment of the eye. In a normal person, both eyes remain relatively parallel and focused on the same target. In the case of strabismus, both eyes do not see the same way, with one eye looking at the object and the other eye looking away from the target, in a skewed state. Folk have different names for strabismus, such as “squinting eye”, “fighting eye”, “opposite eye”, “floating eye”, etc. The skewed eye not only affects one’s appearance, but also causes damage to the visual function and leads to psychological disorders. It can also lead to psychological disorders, which can have adverse effects on learning, choosing a job, choosing a spouse and some special jobs. If the visual function is damaged, it is still possible to restore normal binocular vision and fine stereo vision if timely treatment and correction are provided. What are the symptoms of strabismus? Patients with strabismus may experience double vision, double vision, photophobia, tearing, and a tendency to close one eye to look at things, as well as eye redness, visual fatigue, and other symptoms, sometimes looking very close, while some patients usually show a tilted head to see things, especially when watching TV. The degree of strabismus is relatively stable in some people, while in others, the degree of strabismus is large and small, and can be controlled orthophoria, which is an intermittent strabismus state. Some people with strabismus may not have any symptoms, but only have the appearance of a misaligned eye. How is strabismus caused? Strabismus can be caused by a variety of factors, both congenital and acquired. The congenital causes of strabismus include abnormal development of the brain centers, abnormal development of nerve conduction, abnormal development of the eye muscles and fascia, and even congenital absence of the extraocular muscles in some patients. Genetic factors are also common, and about 1/4 of children with strabismus have genetic factors. In addition, abnormalities during birth, such as obstructed labor, intrauterine asphyxia, and forceps assisted delivery, can damage the eye. These early congenital factors can cause abnormalities in the neuromuscles that govern the eye, resulting in strabismus due to the inability of the eye to turn normally. For adults, acquired factors are mostly caused by systemic diseases, such as neurological diseases, circulatory diseases, endocrine abnormalities, diseases of the five senses, traumatic brain injury, ocular trauma, and orbital occupational lesions. In addition, some poisoning, viral infection, neuritis, myositis, etc. are common causes of strabismus in adults. In children, strabismus is caused by adjustment factors (such as hyperopia), insufficient convergence separation function, congenital myofascial dysplasia, and low visual perceptual function (such as eye lesions), which can easily lead to strabismus caused by eye position separation in children. What should I do when I find strabismus? Children with strabismus should be treated as soon as possible, and the earlier the onset of the disease, the earlier it should be treated, especially during the sensitive period of the child’s visual function development, the easier it is to get effective correction. Once strabismus is detected, we should first understand the child’s visual acuity, and then perform a full refractive state examination under dilated pupils to check for hyperopia, myopia, astigmatism, and amblyopia. If the refractive state is found to be abnormal, the refractive abnormality should be corrected as soon as possible and appropriate glasses should be prescribed. In case of combined poorly corrected amblyopia, different types of amblyopia should be treated according to different conditions and different training methods should be chosen. If the visual acuity is good after wearing glasses or the binocular vision has been corrected well through training or the binocular vision is relatively balanced, but the strabismus still exists, the remaining strabismus should be treated surgically in time to correct the skewed eye position to the best state. In order to facilitate the restoration of binocular vision in children, and to restore the ability to have fine stereopsis. In adults with strabismus, the onset is generally longer and the normal binocular common visual function may be damaged, although some people can have good binocular vision and most of the corrected eye position is cosmetic, but there are also a considerable number of people who have recovered normal binocular visual function and improved binocular visual fatigue and visual discomfort after correcting strabismus. Even after correction of cosmetic strabismus in adults, it is important for patients to get rid of bad psychological barriers because of the improvement of bad eye image. Is strabismus surgery safe? For the correction of strabismus, except for 1/4 of the patients with internal strabismus who can be solved with glasses, most of the rest need to be corrected surgically. In fact, strabismus surgery is one of the safest types of eye surgery. First of all, strabismus surgery does not destroy the internal structure of the eye and does not adversely affect visual function. In addition, the surgery only moves the muscles that govern the rotation of the eye to a different position on the surface of the eye to correct the strabismus. Most general strabismus surgeries are done in one visit, while complex and specific strabismus may require a second surgery, even if the second surgery is still very safe. There is no scarring of the external skin of the eye after strabismus surgery, but the conjunctiva on the surface of the eye will be congested and mildly edematous for the first few days after surgery, which usually subsides quickly. How is surgery for young children managed? First of all, it is best to prepare young children for general anesthesia, as the surgery is easier and safer when the anesthesia is good. The anesthetic drugs and equipment used today are subject to strict safety monitoring and testing, and have been clinically proven to be safe and reliable over many years. How can strabismus be detected early? Obvious strabismus can manifest itself cosmetically, while some strabismus may manifest itself in ways such as photophobia, tearing, and a preference for closing one eye to see. Some patients easily develop visual fatigue and usually tend to see serially, with blurred and unsustainable vision. Some patients like to tilt their heads to look at things, especially watching TV is more obvious. Patients who have a long-term habit of looking at things with a crooked head should be careful not to mistake it for a problem of the neck. These include strabismus, ocular muscle palsy, congenital idiopathic ophthalmoplegia, congenital ophthalmoplegia, ptosis, corneal inflammation, lower lid entropion, refractive error, and many other eye conditions, and even patients who are deaf in one ear can also have crooked head vision. With symptoms of crooked head, further examination, diagnosis and differential diagnosis should be requested from a specialist, and correction of strabismus can be performed after the diagnosis is clear. Everything should not be easily mistaken as a general “crooked neck disease” for improper treatment of muscular shoes.