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Strabismus

What is Strabismus?

Strabismus is a problem caused by the improper functioning of one or more eye muscles, which results in a misalignment of the eyes.

Normally, each eye focuses on the same spot but each sends a slightly different message to the brain. The brain places each image over the other, giving vision its depth and dimension. Even though the images are slightly different, the brain interprets them as one.

Each eye has six muscles that work in together to control movements. The brain controls the eye muscles, which keep the eyes properly aligned. It is critical that the muscles function together for the brain to interpret the image from each eye as a single one.

Strabismus must be detected early in children because they are so adaptable. If a child sees double, his or her brain quickly learns to suppress or block out one of the images to maintain single vision. In a very short time, the brain permanently suppresses vision from the turned eye, causing a weak eye. Children may also develop a head tilt or turn to compensate for the problem and eliminate the double image. Unlike children, adults with a newly acquired strabismus problem typically see double.

Why does strabismus occur?

There are many causes of strabismus. It can be inherited, or it may be caused by trauma, certain diseases, and sometimes eye surgery.

What are its signs and symptoms?

Adults are much more likely to be bothered by symptoms from strabismus than young children. It is unusual for a child to complain of double vision. The following are common signs and symptoms:

• turned or crossed eye
• head tilt or turn
• squinting
• double vision (in some cases)

How can it be detected?

Children should undergo vision screening exams to detect problems early. The younger the child is when strabismus is detected and treated, the better the chance of normal vision. Strabismus is detected with a comprehensive eye exam and special tests used to evaluate the alignment of the eyes such as: the Krimsky test and prism testing.

How is it treated?

The appropriate treatment for strabismus is dependent on several factors including the patient's age, the cause of the problem, and the type and degree of the eye turn. Treatment may include patching, corrective glasses, prisms, or surgery. With patching, the better eye is covered, forcing the child to use the weaker eye. Over time, the brain adjusts to using the weaker eye and vision gradually improves. For this treatment to be effective, it must be done at a young age before the child can develop amblyopia.

Surgery is sometimes performed for both adults and children to straighten a crossed eye. The procedure may be done with local or general anesthesia. There are several different surgical techniques used to correct strabismus. The appropriate one is dependent on the muscle involved and the degree of the eye turn.

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