Strabismus

What is Strabismus (Eye Strabismus)?

The eyes, which perform the visual function, are one of the most important organs in the human body. The deterioration of eye functions due to various reasons can significantly affect the quality of life of individuals. Angular misalignment between the two eyes, namely strabismus, is one of the most common eye diseases. Since strabismus negatively affects the appearance of individuals and causes a significant decrease in the quality of vision, it is a must to treat it.

Both eyes of healthy individuals work parallel and harmoniously. The disruption of the parallelism between the eyes for various reasons is called strabismus. In individuals with strabismus, one of the eyes looks straight while the other one shifts inward, outward, downward or upward. In other words, the eyes are not aligned and one eye is turned in a different direction than the other eye. Due to problems with eye movement control, individuals cannot maintain their normal eye position. Although it may vary depending on the cause of strabismus, these shifts can be temporary or permanent.

What Causes Strabismus?

The harmony between the muscles may be disrupted due to a decrease or increase in strength in one or more of the six muscle groups attached to the outer part of both eyes, which allow the eye to move right, left, down and up. This is one of the factors that cause strabismus. In addition, other known causes of strabismus can be listed as follows:

• Genetic predisposition,
• Down syndrome and other hereditary chromosomal disorders,
• Brain tumors,
• Hypertension,
• Diabetes,
• Cerebral palsy,
• Childhood febrile illness, trauma and accident,
• Hydrocephalus.

What are the Symptoms of Strabismus?

The most common symptoms of strabismus are listed below:

• Eyes looking in different directions
• Blurred vision
• Eye watering
• Headache
• Loss of three-dimensional vision
• Head or face turned to one side
• Pain
• Double vision

In addition to these, bending the head to one side to use one or both eyes in sunny environments or turning the face to one side and looking can also be counted among the symptoms of strabismus. One of the most important issues in terms of children’s visual development is that children are examined by an eye doctor within the first 3 years of age. However, if there is a family history of strabismus or lazy eye, this examination should be done before the age of 3.

If strabismus has not been treated well since childhood in adults, in addition to cosmetic concerns, vision problems and lazy eyes can also be seen. In cases where strabismus develops at an older age, the most common symptom is double vision. In some adults, symptoms such as constantly tilting the head, headache and eye pain can also be seen.

What are the Types of Strabismus?

Strabismus can be categorized in the following ways, depending on the direction of the turned or misaligned eye:

• Inward turning (esotropia)
• Outward turning (exotropia)
• Upward turning (hypertropia)
• Downward turning (hypotropia)

Accommodative esotropia is a type of strabismus that usually occurs when there is uncorrected farsightedness and a genetic predisposition for the eyes to turn inward. Since the ability to focus depends on where the eyes are looking, extra focusing effort is required to keep distant objects at a distance. Symptoms of this type of strabismus may include double vision, occluding one’s vision when looking at a nearby object, or turning or tilting the head. This type of strabismus, which begins in the first few years of life, can usually be treated with glasses. It may also require surgery on the muscles of one or both eyes or the use of an eye patch.

In intermittent exotropia, the eye focuses on a target while the other eye looks outward. Symptoms include double vision, difficulty reading, headache, difficulty reading, and closing one eye when looking at distant objects or in bright light. While ocular deviation is noticed by others, patients may not have any symptoms. On the other hand, intermittent exotopia can be seen at any age. It can be treated with surgery on the muscles of one or both eyes, eye patches, eye exercises and glasses.

Infantile esotropia, another type of strabismus, starts before the age of six months and is characterized by a large inward turning of both eyes in babies. There is usually no significant amount of myoma and the transition is not corrected with glasses. Although the inward turning may start irregularly, it is fixed in a short time due to its nature. The treatment of this type of strabismus, which is seen when the child looks at far and near, is surgery on the muscles of one or both eyes to correct the alignment.

Strabismus is a problem that can also be seen in adults. Often, ocular misalignment in adults develops due to paralysis. It can also be based on physical trauma or a childhood strabismus that has not been treated before or has relapsed or progressed. Procedures such as observation, patch, prism glasses and/or strabismus surgery can be applied for strabismus treatment in adults.

Non-Surgical Strabismus Treatment

For non-surgical strabismus treatment in adults, the amount of strabismus should be very low. In cases where the amount of strabismus is low, the strabismus can be treated with prismatic lenses. Injection treatment can also be applied for strabismus caused by stroke or trauma. It should not be forgotten that early diagnosis is very important for the success of strabismus treatment.

What are the Strabismus Treatment Methods?

Strabismus treatment may vary depending on factors such as the type of strabismus, degree, age of the patient and general health status. Methods such as glasses, oculoplastic surgery, botox injection or surgical procedure to correct the eye muscles can be applied for strabismus treatment. The appropriate treatment is determined and applied according to the patient’s individual condition. The main methods used for the treatment of strabismus can be listed as follows:

Using glasses may be sufficient to correct mild strabismus. Eye squint can be prevented with the use of glasses and the squinted eye can be kept in line with the other eye.

Eye movements can be corrected with eye exercises. Eye exercises that help to correct the coordination between the brain and the eye with muscle control can make it possible for the eyes to look correctly. These exercises can provide positive results if done under the guidance of an ophthalmologist and applied regularly.

In some cases of strabismus, surgical intervention on the eyelids and around the eyes, namely oculoplastic surgery, may be necessary. Within the scope of this procedure, the eyelids or the muscles around the eyes are corrected.

Strabismus can be corrected by temporarily reducing the control of the eye muscles with botox injection. It is a method that can be applied in patients who are not suitable for surgical intervention or in the preparation phase for surgical intervention.

One of the most frequently applied methods for the treatment of strabismus is surgical intervention. Surgical intervention aims to surgically correct the eye muscles. Strabismus is corrected by weakening or strengthening the eye muscles.

Strabismus is a health problem that causes double vision, difficulty reading, headaches and even vision loss in advanced cases. It is possible to prevent or minimize the occurrence of these symptoms with early diagnosis and treatment. Therefore, children should undergo regular eye examinations after the age of 2 to 5.