Strabismus Surgery

Types of Strabismus

Strabismus may present in various forms depending on the direction the affected eye turns:

• Esotropia: The eye turns inward.
• Exotropia: The eye turns outward.
• Hypertropia: The eye turns upward.
• Hypotropia: The eye turns downward.

These types can be classified further based on whether they occur intermittently or constantly, if they affect one eye or alternate between both, or if they result from nerve dysfunction.

Common Forms of Strabismus

Some types of strabismus include:

• Accommodative Esotropia: Caused by uncorrected farsightedness, it often affects children with a family history of eye-turning conditions. Extra effort to focus on distant objects can cause the eye to turn inward.
• Intermittent Exotropia: One eye may focus on a target while the other eye turns outward. This misalignment often shifts between looking straight and turning outward.
• Infantile Esotropia: This occurs in babies, with both eyes turning inward by six months of age. Often uncorrected by glasses, it usually requires surgical correction for alignment.

How Common is Strabismus?

Globally, around 4% of the population experiences some form of strabismus, affecting individuals across all age groups.

Symptoms and Causes of Strabismus

Symptoms

Signs of strabismus may include:

• Double vision
• Tilting or turning of the head
• Difficulty reading or eye strain
• Covering one eye to see better

In young children, strabismus often appears by the age of three, although occasional misalignment is typical in newborns. By three to four months, a baby’s eyes should focus on small objects, and by six months, alignment should be well established. Sudden eye misalignment in older children or adults may suggest a neurological issue and should prompt immediate medical attention.

Causes of Strabismus

Strabismus usually arises from neuromuscular control issues related to the brain. Family history is a strong factor, with nearly 30% of children with strabismus having relatives with similar issues. Other risk factors include:

• Uncorrected vision issues
• Neurological conditions like cerebral palsy
• Down syndrome (20-60% prevalence)
• Stroke or head trauma
• Graves’ disease (thyroid disorder)

Complications of Untreated Strabismus

Without treatment, strabismus can result in:

• Lazy Eye (Amblyopia): When the brain ignores input from the misaligned eye, leading to poor vision in that eye.
• Blurry or Double Vision: Affecting daily activities, work, and school performance.
• Reduced Depth Perception: Affecting coordination and activities that rely on 3D vision.

Diagnosis and Testing for Strabismus

At Visualis Eye Clinic, we recommend any child over four months with visible misalignment undergo a full examination. Our assessment includes:

• Medical History Review: Understanding symptoms, family history, and overall health.
• Visual Acuity Test: A child-friendly eye exam to assess vision.
• Refraction Test: Using corrective lenses to see how the eyes focus light.
• Alignment and Focus Evaluation: To determine the degree and consistency of misalignment.

Treatment Options for Strabismus

Our treatment recommendations vary by case but may include:

• Glasses or Contact Lenses: For refractive errors that cause misalignment.
• Prism Lenses: To correct double vision by bending light entering the eye.
• Orthoptic Exercises: For convergence insufficiency, particularly for cases of intermittent exotropia.
• Medications: Eye drops, ointments, or botulinum toxin injections to weaken specific muscles and aid alignment.
• Patching: To address amblyopia in cases where one eye is weaker.
• Eye Muscle Surgery: An outpatient procedure that adjusts the eye muscles for proper alignment.

We also provide regular follow-ups to monitor your response to treatments, making necessary adjustments as needed.

Can Strabismus Be Prevented?

While strabismus itself is not preventable, early detection can protect against complications. We encourage parents to seek evaluation for their children if they notice any misalignment. For adults, especially those with a history of stroke or head injury, regular eye checkups are essential.

Prognosis and Long-Term Outlook

With timely diagnosis and treatment at Visualis Eye Clinic, most children can achieve excellent visual outcomes, and treatments are effective for adults as well. Addressing strabismus early can prevent complications and preserve visual health and self-confidence.

When to Seek Help

If you notice any signs of strabismus in yourself or your child, contact Visualis Eye Clinic. Our team specializes in managing eye misalignment with personalized care and advanced treatments. A sudden onset of misalignment, especially with double vision, should prompt immediate medical attention.