What is it
Strabismus
It is a visual defect that consists of the deviation of one or both eyes in one of the positions of the gaze, as a result of the lack of coordination between the eye muscles. This causes the loss of parallelism between the two eyes and incorrect binocular vision , affecting the ability to see in relief, calculate distances and see in 3D.
Small intermittent deviations may appear before 6 months, without necessarily being associated with any problems. This functional strabismus of newborns is known as congenital strabismus. However, you should visit the ophthalmologist when it is a permanent deviation. It should be borne in mind that, if strabismus is not corrected early, that is, before the age of 7-8 approximately, the decrease in vision in the deviated eye can become permanent and irreversible.
Amblyopia or lazy eye is the most serious consequence of strabismus and the most frequent cause of unilateral visual loss (vision in only one eye) in children and young people. The child who suffers from lazy eye uses one eye less than the other, which becomes “lazy”.
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Strabismus can be classified according to different criteria such as the direction of deviation (convergent, divergent and vertical), persistence over time (temporary and permanent) and the dominance or not of one eye. In this case, strabismus can occur alternately, that is, sometimes the child looks with one eye (dominant eye) and deviates the other, and other times, it does it the other way around. The dominant eye can alternate or always be the same.
The origin of strabismus is mainly related to alterations in the functioning of the eye muscles, differences in vision between the two eyes due to associated refractive errors and trauma that exerts pressure on the eye.
Treatment
Strabismus in children should be treated early by an ophthalmologist to avoid the appearance of amblyopia or lazy eye and to have a better functional prognosis. However, it is also worth considering the aesthetic and psychological effects on the child of having one (or both) eyes deviated.
In the patient’s previous ophthalmological examination, the specialist must study the angle of strabismus and the cause that has originated it, in addition to taking into account their age when establishing the most appropriate treatment. This treatment must be approached from a double perspective, that is, taking into account the consequences on the functioning of vision and the aesthetic consequences of strabismus.
When it comes to congenital strabismus (from birth), treatment should be started from the first months and consists of placing a patch over the healthy eye to stimulate the lazy eye. In the case of accommodative strabismus, in which there is a previous refractive error (myopia, hyperopia, astigmatism), it is advisable to treat it with optical correction (glasses or contact lenses). Strabismus usually disappears once the refractive error has been corrected.
In children who have developed lazy eye (amblyopia), the goal is to regain vision in the eye, which is usually achieved by occlusion of the healthy eye with a patch.
In the event that the ocular deviation persists, once the refractive errors and amblyopia have been corrected by means of glasses and/or patches, it is necessary to resort to surgical treatment to correct the loss of parallelism between the two eyes, as they are not correctly aligned.
Childhood strabismus surgery consists of modifying the length or position of the muscles of the ocular system, which are responsible for moving the eyeball, strengthening or weakening those responsible for the deviation of the eye. Given the young age of the patient, this procedure is performed under general anesthesia and on an outpatient basis.
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