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Strabismus

Strabismus is a general term referring to ocular misalignment due to extraocular muscle imbalance. One eye may look straight ahead, while the other eye turns inward, outward, upward or downward. In short, the eyes are "crooked". Strabismus occurs in approximately 2% of children under 3 years of age and about 3% of children and young adults. Strabismus is important to recognize, primarily because, in childhood, it is often associated with the development of amblyopia , or lazy eye. Strabismus has an inherited pattern, i.e., it is much more likely if one or both parents are affected. Strabismus most often begins in early childhood. It is sometimes called "cross-eyes," "walleye," or "squint." Strabismus occurs when the eye muscles do not work properly to control eye movement. Strabismus is a common condition among children. About 4 percent of all children in the United States have strabismus. Strabismus occurs equally in males and females. Strabismus may run in families however, many people with strabismus have no relatives with the problem. When the eye muscles do not work correctly, the eyes may become misaligned, and the brain may not be able to merge the two images.

Strabismus is a deviation of the eyes. Strabismus is commonly known as crossed eyes, wandering eyes or floating eyes. Strabismus in adults can also result from illnesses, such as thyroid disease, or from an eye injury. If vision is reduced, the brain of the child will learn to recognize the stronger image and ignore the weaker image of the amblyopic eye. Strabismus is associated with reduction of depth perception and if onset is in adulthood, double vision. Furthermore, strabismus presents a cosmetic concern especially for school-age children.  In addition to problems with vision, strabismus affects appearance and communication because it diminishes one's ability to make eye contact, which can become a disadvantage in both personal and professional livelihood. At Children's Hospital Boston, pediatric ophthalmologists who specialize in the delicate eye muscle surgery required to fix strabismus see both children and adults.

Causes of Strabismus

The common Causes of Strabismus :

• Most cases of strabismus in children are of unknown cause.
• Loss of vision in one eye from any cause will usually cause the eye to gradually turn outward.
• A family history of the disease is a known risk factor.
• Squint results from unequal pulling of muscles on one side of the eye, or a paralysis of the eye muscles.
• Rarely, squint may be due to cataract or a serious condition like a tumour.
• Another common cause of strabismus is farsightedness (hyperopia) which may cause the eyes to turn inwards (crossed-eyes).
• Squint in adults may result from injuries to the orbit or brain, including closed head injuries and strokes.

Symptoms of Strabismus

Some Symptoms of Strabismus :

• Uncoordinated eye movements.
• Eyes that do not align in the same direction .
• Double vision.
• Eyes that appear crossed .
• Decreased vision .
• Misaligned eyes.
• Vision in only one eye with loss of depth perception .

Treatment of Strabismus

• Glasses or contact lenses may be prescribed to improve your ability to focus and help overcome poor vision. With better eyesight, strabismus may improve.
• Eye drops or ointment may be put in the good eye to blur the vision (usually by making the pupil large and preventing the eye from focusing well). This forces the affected eye to fixate properly and may be used as a substitute for patching.
• Vision training (also called eye exercises)
• The squint is treated by surgery . A tight muscle is surgically loosened by moving the muscle back on the eye. A weak muscle is strengthened by removing a small segment of the muscle to shorten it. Depending on the severity of the strabismus, surgery may involve the straight eye, the misaligned eye or both.
• In rare cases, injections of botulinum toxin may also be used to treat strabismus.
• Treatment for strabismus works to straighten the eyes and restore binocular (two-eyed) vision.

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