Strabismus, also known as squint, is a condition where the eyes fail to align properly, leading to asymmetry in eye movement. It affects 4% of people and can be permanent or temporary.
This condition can occur in both adults and children, with varying causes and associated vision disorders. Turkey has become a leading destination for treating strabismus, with advanced techniques offered by specialized teams.
Strabismus can cause the eyes to not work together, affecting one eye consistently or alternating between both. In congenital cases, the brain may ignore signals from the misaligned eye, leading to amblyopia.
Strabismus’s definition and types
Strabismus is an optical defect that causes the eyes to move in a non-parallel and unbalanced manner so that the optical axes do not meet at a single point, causing diplopia and double vision for the patient.
The eye has six muscles that are responsible for moving it in different directions. These muscles work symmetrically to maintain balance and ensure the movements of both eyes are coordinated. As the eyes focus on an object, the two visual axes meet at a single point. The brain helps the two images from each eye merge into one three-dimensional image, a complex process that the brain carefully coordinates.
Strabismus is a common condition affecting an estimated 13 million people in the United States. It can be categorized based on the direction of the eye’s deviation:
- Esotropia: The eye deviates inward toward the nose.
- Exotropia: The eye deviates outward toward the ear.
- Hypertropia: The eye deviates upward.
- Hypotropia: The eye deviates downward.
Types of crossed eyes
Strabismus or squint eyes have two basic types:
1. Comitant strabismus:
In this case, the angle of strabismus is constant (how far the eye deviates) in all directions of gaze.
2. Incomitant strabismus:
Incomitant strabismus occurs when the angle of deviation changes with the direction of gaze, often due to paralysis or weakness of the eye muscles.
It can affect individuals of all ages, but it commonly appears in infancy. Internal strabismus is seen in the first months of life, while accommodative esotropia, caused by hyperopia, typically develops between ages two and three.
Acquired strabismus develops later in life, often resulting from weakness or paralysis of one or both eye muscles.
3. Hidden squinting (lines):
Squinting may only become noticeable under stress or when the other eye is covered during a medical exam, causing hidden strabismus to become visible due to fatigue, such as in the evening. It often disappears upon waking in the morning.
This type can lead to blurred vision, difficulty reading letters and words, and severe headaches after prolonged activity, such as working for two hours.
4. False squint:
Some babies are born with a wide nasal bridge and a skin fold over the inner corner of the eye, giving the appearance of squinting.
This condition may regress by the age of six months.
What are the causes of squinting?
The causes vary from case to case, and in some cases, the cause remains unknown; here are the most important causes :
- Poor vision in one eye (moderate to severe hyperopia, a difference in refractive power in one eye relative to the other, or less common issues such as congenital cataracts).
- Inflammatory conditions such as meningitis and polyneuritis
- Cerebral vascular lesions such as cerebral aneurysms.
- Down syndrome
- Hydrocephalus is a developmental disorder that results in fluid buildup in the brain.
- Brain tumors.
- Stroke.
- Injury to the nerves responsible for moving the eye muscles (congenital or acquired).
What are the symptoms of strabismus?
Squinting has many different symptoms:
- Visual stress: Red, burning eyes, headache
- Difficulty reading and a child’s academic performance
- Diversion (Double Vision)
- Determined by eye movements
- Sometimes, it can be accompanied by squinting of the upper eyelid.
Strabismus diagnosis
A routine eye exam at every pediatrician visit is used to diagnose strabismus in children, but if you complain of symptoms, visual impairment, or other eye disorders at any age, an ophthalmologist should perform a complete eye exam.
What is a strabismus test?
The test or corneal light reflex The doctor directs the light perpendicularly to the patient’s pupil; in the case of this disease, the doctor notices that the corneal light reflex is displaced from the center of the pupil in the strabismic eye.
This test diagnoses squinting.
What are the complications of strabismus?
It results in many visual, cosmetic, and sometimes psychological complications:
Visual complications: It can lead to a vision disorder such as glaucoma. One of the main complications is the development of amblyopia, or lazy eye, which results from the brain neglecting images coming from one eye.
In most cases, This disease causes an aesthetic disturbance in the appearance of the face and can sometimes lead to psychological disorders in the sufferer.
How to treat strabismus?
Treatment varies depending on the causative factor. If hyperopia is the cause, glasses or contact lenses can be used to correct it. Amblyopia, which can be both a cause and a consequence of squinting, can be treated by covering the healthy eye with a patch to stimulate the affected eye. In some cases, surgery may be needed to correct the muscles of the affected eye to restore the eye’s balance.
Strabismus surgery
The basic principle of hula corrections is:
- Delaying the attachment of the strong muscle to the eyeball, i.e., moving it backward to weaken the muscle’s ability to tighten.
- Shortening the weak muscle (i.e., myotomy) to strengthen it.
This is done in amounts that vary depending on the angle of strabismus as determined by the doctor.
General anesthesia is used for most children, while adults are performed under local anesthesia, and the type of anesthesia depends on the patient, the presence of health conditions, and their preferences.
After surgery, it’s normal for the white-colored sclera of the eye to turn red.
It may take several weeks or sometimes months for the redness to disappear.
The eyes are usually blurry and painful to move.
The pain usually improves after a few days, depending on the exact surgery that was performed.
The final result is visible four to six weeks after the surgery; children under the age of 10 may need to repeat the procedure to maintain the best results, and in some cases, prismatic glasses may help to adjust the movement of both eyes.
There is a modern treatment method based on Botox injections, which is effective for mild cases.
Some may use prisms and orthoptics as a complementary treatment to surgery in certain cases, such as intermittent strabismus, while prisms and glasses are used when diplopia is present.
Exercise therapy for strabismus
This method is used in the treatment of lateral strabismus during near vision, and the simple exercise can be performed as follows:
Hold a pen in your hand and slowly bring it closer to your nose while fixing your gaze on it until diplopia occurs. Repeat this exercise several times a day for several weeks until the distance at which you experience diplopia becomes smaller.
Unfortunately, muscle exercises are only temporarily beneficial and must be repeated periodically to control symptoms.
Can strabismus be prevented?
It cannot be prevented, but early diagnosis prevents complications.
Bimaristan Medical Center remains your first choice for treatment in Turkey.
We direct you to the best and most famous specialists in all fields. Do not hesitate to contact us at Bimaristan Family Medical Center in Turkey. You can also read about the latest ophthalmology technologies in Turkey on our website.
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