Our eyes, one of our most important sensory organs, directly affect our quality of life by managing our sense of sight. Problems experienced in our eyes can disrupt both the quality of our vision and the anatomical structure of our eyes.
Strabismus is one of the common eye problems. This problem occurs due to the distortion of parallelism between the two eyes; It creates an aesthetic problem because it disrupts the normal appearance of the eyes. However, more importantly, it also negatively affects the quality of vision and depth perception in most patients, so early diagnosis and early initiation of treatment are of great importance. Since the problems caused by this disease are not well known, most of our patients want to get information about strabismus and its treatment.
What is Strabismus?
In normal healthy people, both eyes are located in an angular proportion within the eyeballs. Strabismus is the distortion of the almost parallel alignment angle between these two eyes. In some patients, the definition of strabismus may also appear as impaired functional synchronization of the eyes. When people's two eyes cannot work in coordination; Both the visual alignment of the eyes is disrupted and the quality of vision is impaired. Sometimes, in eyes with low visual acuity, when there is no effect on the visual functions of the eye, misalignment may develop in the future. Although the strabismus problem generally seems to negatively affect people only visually, in fact, people's visual acuity and visual functions are also negatively affected by this condition.
What Causes Strabismus?
There are many reasons that cause strabismus. The most common of these is the weakness in any one or more of the 6 muscles around the eyes. These muscles allow the eye to move up/down (in the vertical plane) or right/left (in the horizontal plane). Any congenital or acquired problem in these muscles causes strabismus in people. In addition, there are other diseases that can be listed as causes of strabismus. These can be listed as follows:
Accidents, feverish diseases and head traumas during childhood
Cerebral palsy (brain palsy) disease
Down syndrome and other hereditary chromosomal disorders
Eye muscle paralysis that develops with vascular problems such as hypertension and diabetes
Various neurological diseases (Multiple Sclerosis, Myasthenia Gravis etc.)
Strabismus; It may be an eye disorder on its own, or it may occur as a result of another systemic disorder. Therefore, when strabismus is encountered, the presence of additional systemic findings should be carefully questioned. Especially when adults experience strabismus, the presence of various internal and neurological diseases should be investigated.
What are the symptoms of strabismus?
Strabismus is an important eye disorder that often occurs in childhood. Sometimes it can occur in adulthood or later. A problem sometimes described as false eye deviation can be confused with true strabismus. In childhood, since the anatomical ratio and structural development of the eyelids and the root of the nose have not yet been completed, the distance between the child's pupils may be perceived differently than normal. This condition can create a misleading picture similar to strabismus. As the child gets older, the appearance of false strabismus disappears with the changing facial structure.
However, a true strabismus does not regress as the child gets older. The most common complaints of children and adults diagnosed with strabismus at the time of admission are;
Creating a head position (positioning the head or eyes in one direction) (creation)
Head and eye pain
Loss of three-dimensional vision ability
Strabismus is not always apparent from the outside. Since some people may have mild strabismus, they may not notice this problem at first. In this case, these findings may become evident as the strabismus progresses (manifest strabismus).
What are the Types of Strabismus?
The problem of strabismus is divided into different types according to the underlying problem and the shape of the shift. Strabismus is terminologically defined according to its shape as horizontal shifts such as inward/outward deviation and vertical (vertical) deviations. Congenital They are also classified according to their form of formation, such as acquired slips. In addition to these, some other types of strabismus defined according to the cause of formation are as follows:
Stribs that is due to refractive error or accommodation (refractive/accommodative)
Stribs that is due to muscle paralysis (paralytic)
Strabismus due to muscle compression (restrictive)
How is Strabismus Diagnosed?
Some ophthalmological tests are used to diagnose strabismus. In addition to these detailed tests performed by ophthalmologists, some screening tests that can be performed by family physicians or pediatricians can help in the early diagnosis of strabismus.
Is strabismus a disease that can be treated?
The treatment plan for strabismus can be made after determining the type of strabismus. Strabismus types that occur from birth and are detected in infancy/childhood are examined by an ophthalmologist through a detailed ophthalmological examination. In types of strabismus that occur secondary to an underlying disease, a detailed eye examination and, if necessary, a neurological examination are performed. In the presence of an underlying disease, the underlying disease must be treated first to treat strabismus.
The treatment of strabismus varies depending on the type of strabismus. While the type of strabismus due to refractive error can be treated with the use of glasses; Some types of strabismus (for example, paralytic or restrictive strabismus that is not due to refractive errors) are treated with surgical methods. The treatment response to strabismus treatment is not the same in every patient, but strabismus can be defined as a disease that can be treated to a large extent with early diagnosis and selection of the right method.
Strabismus Treatment Methods
Strabismus treatment methods, strabismus treatment methods, varies depending on the type. Each patient requires treatment according to their own eye findings, in line with a plan made by the ophthalmologist. Planning in strabismus treatment begins with determining the type of strabismus. A simple optical correction method such as the use of glasses has a therapeutic feature in strabismus due to refractive errors, especially hyperopia. In some paralytic strabismus It is possible to reduce strabismus with methods such as the use of glasses containing David prismatic glass and injection of Botulinum Toxin into the extraocular muscles. In patients who do not respond to these methods or in some cases of congenital strabismus, the treatment method used is strabismus surgery. Especially in some types of strabismus diagnosed in infancy (infantile strabismus), early surgical intervention can effectively correct this problem. However, it is not possible to get the same results in every patient in strabismus surgery, because the factors affecting surgical success vary, especially in patients with neurological problems.
Treatment of Strabismus in Children
Treatment of strabismus in children is of great importance because the patients' response to treatment is better in childhood and this treatment has a great impact on the child's future life.
The aim of strabismus treatment is to restore the parallel structure of the eye, as well as to preserve the patient's visual acuity and depth perception. Strabismus is an important factor causing amblyopia, and one of the aims of early treatment is to prevent the development of amblyopia in the patient. Because a wandering eye cannot carry visual stimuli efficiently and prevents the development of a person's advanced visual functions such as three-dimensional vision and depth perception. In this case, a strabismus patient who is not treated early will develop amblyopia and will not be able to respond to treatment in the following years.
When you suspect your child has strabismus, it is important to consult an ophthalmologist without delay and request a detailed eye examination for your child's visual abilities in later life.
Treatment of Strabismus in Adults
Strabismus problem that occurs in adults is generally one of the types of acquired strabismus that is not due to refractive errors. It usually develops due to an underlying neurological or internal problem. However, in some patients, the strabismus problem is noticed at an adult age, or treatment of this problem may be requested at an adult age. Strabismus that develops later; In cases of paralytic strabismus, prismatic glasses or Botulinum to extraocular muscles While methods such as toxin injection can be applied, priority is given to the treatment of the neurological condition in cases of strabismus seen in some neurological diseases.
Although strabismus surgery in adults is not as effective as in children, strabismus surgery in older ages is mostly performed only for cosmetic correction.