Strabismus: Types, Symptoms, and Treatment

August 1, 2022

Normal eyes should appear aligned with each other. But when they do not line up properly where the one straight eye takes precedence, your eyes will appear misaligned. This is called strabismus and is often called crossed eyes. The acuity of a strong eye remains normal because it is connected well to the brain. However, the misaligned or weaker one does not focus properly and its linkage to the brain does not develop properly.  Strabismus can be rather noticeable sometimes. But in some cases, it can only be detected when the children are feeling tired or looking at something so closely. Strabismus can present at birth or develop during childhood. It is most commonly caused by a problem with the muscles that move the eyes, but may also run in families.

Type of Strabismus

Strabismus can be treated if it is caught early enough. But the brain will gradually ignore the visual images of the weaker eye if it is not treated. So it is best to familiarize yourself with the types of strabismus that may occur so you know what to do next.
1. Inward turning (Esotropia)
Esotropia is a type of eye misalignment that causes one or both eyes to turn inward. It may be intermittent or continuous, and it can happen with either close or far fixation or even both. This will happen at any age.
2. Outward turning (Exotropia)
When the eye turns outward, it is called exotropia which may be presented in many ways. It can be constant, intermittent, unilateral, alternating, and extend in magnitude.
3. Upward turning (Hypertropia)
Rather than the eyes turning inward or outward, which makes the eyes appear crossed, hypertropia occurs when one eye moves upward.
4. Downward turning (Hypotropia)
Hypotropia is a kind of vertical strabismus in which one eye goes downwards in comparison to the other eye.

Symptoms of Strabismus

The majority of children with strabismus do not usually whine about having difficulties seeing or any eye problems they may have. It is the family member, teacher, or health care professional the ones who often notice that their eyes are not aligned. So, you should be aware of these signs your children might present.
1. Eye squinting
The child might develop a habit of squinting or always rubbing on only one eye. And when they are trying to look at you, they often turn their head or one of their eyes is shut. Parents should bring their children to the eye specialist to be checked if the children are experiencing double vision.
2. Eyes don’t always stare in the same direction
The eyes of a newborn might be misaligned from the beginning of birth. But, the eyes should already be straight after 3 to 4 months of life. In several scenarios, the child’s eyes do not look straight simply because the bridge of the nose is wide, making the eyes look crossed.
3. Tilting of the head
Children tilting their heads are their way of lining up their eyes in order to use them together, especially under the shiny sunlight. By doing this, they block out a double image as a result of misaligned eyes that points in different directions.
4. Vision changes
This is quite similar to double vision – seeing two in one image. Another vision change that may happen is fuzzy visuals which the child could have a hard time reading or loss of depth perception.
5. Problem judging the distance
Since binocular vision is crucial in judging depth, children with poor binocular vision may act awkwardly and clumsily. Other than that, a loss of hand-to-eye coordination is another symptom of strabismus. Hence, since the children have no sense of distance, they might not enjoy playing catch.

Treatment of Strabismus

Everything will turn out fine if any health issue is treated early. There are several treatments of strabismus that you may opt for. Let’s read down below.
1. Eye examination
Doing an eye examination allows specialists to examine the history of the patient. This is to uncover the patient’s symptoms, family history, common health issues, used medication, and any other possible reasons for the symptoms. Through eye exams, we can examine the visual acuity of the child as well by making the children read the eye chart. The child may be tested with corrective lenses as well to identify how their eyes focus light. To further examine, the eye specialist will perform an alignment and focus test. This is conducted by checking the widening of the pupil to dictate the health of the internal eye structure.
2. Eyeglasses or contact lenses
This treatment is used for those who have not had their refractive errors repaired. Hence, using corrective lenses will require less effort to focus and keep the eyes straight.
3. Prism lenses
To look at the objects, using special lenses that can bend the light that enters the eye will do the trick. It also helps to reduce the turning of the eye so the eyes can appear straight.
4. Orthoptics
This treatment is eye exercises designed to assess the alignment of the eye, its movement, and binocular vision. It is to help achieve the control of strabismus in a small set of individuals, especially among people who face convergence insufficiency – a form of exotropia.
5. Patching
Patching is usually used to treat lazy eyes, but this method may also cure a patient with strabismus. Because the improvement of vision may also contribute to the control of the eye misalignment.
6. Eye muscle surgery
The length or location of the eye muscles is altered during surgery in order to align the eyes appropriately. When performing this surgery, general anesthesia and dissolvable sutures are used. Adjustable strabismus surgery, in which the eye muscle locations are altered after surgery, is occasionally offered to adults with strabismus.

Final Say

Strabismus usually appears in infants and young children commonly by the age of three. People frequently believe that a child with strabismus will grow out of it. However, this is not the case. In fact, strabismus may worsen if left untreated. You may bring your child to VISTA Eye Specialist Centre to have a regular eye check-up if you suspect they have strabismus. All of our eye specialists are qualified and highly experienced to perform eye examination procedures.


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