There is not a single cause for the development of strabismus. A problematic pregnancy period, whether the birth was problematic, the child’s development, and illnesses they have had can lead to strabismus. There is a genetic predisposition for strabismus. If there is a family history of eye misalignment, the chances of strabismus occurring in children increase.
In childhood, strabismus occurring after the age of 2 is generally due to eye disorders. In a child predisposed to strabismus, eye misalignment may begin after a feverish illness or a trauma (fall, surgeries, accidents).
The center in the brain that controls the movement of our eye muscles, so paralysis occurring in the nerves can also cause eye misalignment. Accidents, head trauma, febrile illnesses, and conditions such as hypertension and diabetes at an advanced age can cause paralysis in the nerves of the eye. Treatment for strabismus resulting from such conditions can vary depending on whether the paralysis is permanent. Amblyopia in children must be treated because it can cause double vision in older age groups.
Types of Strabismus
Strabismus is named according to the directions in which the eyes deviate.
Inward strabismus (Esotropia) Outward strabismus (Exotropia) Upward strabismus (Hypertropia) Downward strabismus (Hypotropia) There are also special types of strabismus that do not fit into this classification;
Causes of Strabismus…
There is not a single cause for the development of strabismus. A problematic pregnancy period, whether the birth was problematic, the child’s development, and illnesses they have had can lead to strabismus. There is a genetic predisposition for strabismus. If there is a family history of eye misalignment, the chances of strabismus occurring in children increase.
In childhood, strabismus occurring after the age of 2 is generally due to eye disorders. In a child predisposed to strabismus, eye misalignment may begin after a feverish illness or a trauma (fall, surgeries, accidents).
The center in the brain that controls the movement of our eye muscles, so paralysis occurring in the nerves can also cause eye misalignment. Accidents, head trauma, febrile illnesses, and conditions such as hypertension and diabetes at an advanced age can cause paralysis in the nerves of the eye. Treatment for strabismus resulting from such conditions can vary depending on whether the paralysis is permanent. Amblyopia in children must be treated because it can cause double vision in older age groups.
Types of Strabismus
Strabismus is named according to the directions in which the eyes deviate.
Inward strabismus (Esotropia) Outward strabismus (Exotropia) Upward strabismus (Hypertropia) Downward strabismus (Hypotropia) There are also special types of strabismus that do not fit into this classification;
Strabismus Seen in Adults
Strabismus occurring in adulthood can be due to various reasons affecting the nerves that control eye movements (trauma, diabetes, cardiovascular diseases, hypertension, various infections, tumors, or poisonings). Treatment should first focus on the underlying causes of strabismus. Surgery may be necessary after a certain period, especially in cases where there is also complaints of double vision. In the treatment of strabismus, besides the use of glasses, orthoptic therapy using special devices, patching therapy, medical treatment with various drops, and surgical treatment can be applied.
Hidden Strabismus
Hidden strabismus is misalignment that becomes apparent when one eye is covered. Hidden deviation is a common eye condition in our country. While both eyes are open, the brain ensures that the eyes remain parallel with a connecting mechanism. However, when one eye is covered, this mechanism is disrupted, and misalignment occurs in the covered eye.
In such cases, the patient is usually unaware of the deviation and seeks medical help due to complaints such as eye fatigue, redness, pain, dryness, and headaches. If the patient also has a vision problem, these complaints may arise earlier. Especially after close reading, the patient complains of headaches. Hidden strabismus can be treated with appropriate glasses and orthoptic (with special devices) exercises.
How Is Strabismus Treated?
Since strabismus can originate from many causes, the treatment varies from person to person.
Glasses: Some types of strabismus occur due to refractive errors. When the patient starts wearing glasses, the strabismus improves. Glasses are sufficient for such types of strabismus. Patching Therapy: This treatment method can be applied if there is amblyopia in the patient’s eye. Orthoptic Therapy: This treatment is applied to improve the vision and depth perception with both eyes. These two functions not only ensure that the eyes remain parallel but are also crucial in our daily lives. It helps us to be more comfortable and successful when driving, playing sports that require distance and time adjustment such as basketball and tennis. Surgical Intervention: Congenital deviations usually require surgery, which typically does not require glasses and should be performed at an early age (6 months to 1 year). Most deviations occur around the age of 2–3 and can usually be corrected with glasses. Surgical treatment is required for deviations that do not improve even with glasses. Strabismus surgeries are usually performed under general anesthesia. The basic principle of surgery is to reduce or increase the force of the muscles attached to the eyeball or to change their positions. Early diagnosis and treatment can prevent amblyopia and provide three-dimensional vision. Therefore, any child with suspected strabismus should be taken to an ophthalmologist specializing in strabismus without waiting for a certain age. Botox: In some cases of strabismus, botulinum toxin (BOTOX) can also be used in treatment. BOTOX can be effective in deviations caused by paralysis, in cases where complete recovery has not been achieved after surgery, and in cases of eye misalignment due to thyroid disease. Deviations that occur suddenly due to paralysis generally cause double vision and are quite difficult for the patient. The general tendency in such deviations is to wait for 6–8 months, but BOTOX application can be performed during the waiting period to reduce double vision. Immediate treatment after the onset of strabismus can lead to complete recovery.
