What Is It?
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Strabismus is visual defects in which eyes are misalign and
point in different directions. For example, the left eye might be looking straight
but the right eye might be looking downwards. However, as time pass, the straight
eye might turn and the turned eye might straighten. Strabismus is common among
children and about 4% of the children in United States have strabismus. However,
it can also occur in later life and is equally common in both males and females.
Strabismus may also run in families. However, not all people with strabismus have
relatives with the problems. |
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| Causes
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The exact cause of strabismus is not fully understood. However,
it is believed that strabismus occurs when the six eye muscles are not coordinated.
As the brain controls the eye muscles, strabismus is especially common among children
with disorder that affect the brain such as:
- Cerebral palsy
- Down syndrome
- Hydrocephalus
- Brain tumors
A cataract or eye injury that affects vision can also cause strabismus. |
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| Symptoms
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The main symptom of strabismus is an eye that is not straight.
Sometimes children will squint one eye in bright sunlight or tilt their head to
use their eyes together. |
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| Diagnostics
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Strabismus could be diagnosed during an eye exam. Children
should have their vision checked before the age of four. If there is a family
history of strabismus of amblyopia, he should have the vision checked even earlier
than the age of three. The eyes of infants often seemed to be crossed. Young
children who have wide, flat nose and a fold of skin at the inner eyelid can
make the eyes appear crossed. This "fake" strabismus will improve as the child
grows. However, one would not outgrow the real strabismus. |
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| Types
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There are basically three types of strabismus, namely:
- Esotropia is a common type of strabismus among
infants where the eye turns inward, causing the infant not able to use their eyes
together. Early surgery can align the eyes. During the surgery, the tension of the
eye muscles in one or both the eyes is adjusted. The tighter inner muscles are
removed and placed further back on the eye so as to pull the eye outward. Sometimes,
the outer muscles is tightened or shortened instead to pull the eye outward.
- Accommodative esotropia is a common form of esotropia that occurs in farsighted
children. When young, the child can focus the eyes to enable himself or herself
to see. However, the effort used to focus causes the eyes to cross. Spectacles
can reduce the focusing effort and straightened the eye. Sometimes, bifocals,
eye drops, ointment or special lens called prism are used instead to straighten
the eye.
- Exotropia is another common types of strabismus that the eye turns outwards.
This happened when a child is focusing on distant objects. However, it happens
only from time to time, especially when the child is daydreaming, ill or tired.
Glasses, exercises or prisms might reduce or help control the outward turning
eye, but a surgery is usually needed.
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| Surgery
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The eyeball is never removed during the surgery. The
ophthalmologist makes a small incision in the tissue to reach the eye muscles.
Certain muscles in one or both eyes are repositioned. A general anesthetic
is required for a child but local anesthesia is optional for adults. Most
patients can resume their activities in about a few day times. Glasses or
prisms might be useful after the surgery. In many cases, a further surgery
might be needed to keep the eye straight.
For children with strabismus, it is more advisable for them to go for a
surgery early. It would be easier for them to undergo a surgery before
school age. Eye muscle surgery involved risk such as infection, bleeding,
excessive scarring and other rare complications which might lead to the
loss of vision. However, strabismus is usually safe and effective treatment
for eye misalignment.
An alternative to surgery is to inject a drug know as Botox into the eye
to allow the muscles to relax temporarily, allowing the opposite muscles
to tighten and hence straighten the eye. Though the drug might wear off
in a few week, the misalignment might be corrected for good. |
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