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Strabismus is an eye alignment disorder that occurs as a result of both eyes being unable to focus on the same point. While one eye looks straight ahead, the other eye may turn inward, outward, upward, or downward. This condition, which can be seen in both children and adults, can lead to permanent vision problems if not diagnosed early.
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What Causes Strabismus in Children?
Strabismus in children is a condition that arises from the inability of the eyes to maintain parallel alignment. This disorder can be caused by various factors such as genetic predisposition, refractive errors, premature birth, and neurological transmission problems. Additionally, pseudostrabismus, which is common in newborns, can create the impression of an eye turn due to anatomical features and usually resolves on its own over time.
- Refractive Errors: Refractive errors such as hyperopia or astigmatism can lead to strabismus in children. High hyperopia, in particular, can cause an inward turn (esotropia) as the eyes exert excessive effort to obtain a clear image.
- Genetic Predisposition: Children with a family history of strabismus have an increased risk of developing the condition. Genetic factors can predispose a child to this condition by affecting the control of the eye muscles.
- Premature Birth and Retinopathy of Prematurity (ROP): In infants born prematurely, the risk of strabismus is high because the ocular and nervous systems are not fully developed. Premature birth can lead to eye diseases like retinopathy of prematurity, and consequently, to eye turns.
- Pseudostrabismus: In newborns, the eyes may appear to be misaligned due to the width of the nasal bridge and the skin folds of the eyelids (epicanthal folds). This is pseudostrabismus, which arises from anatomical features, and it typically self-corrects as the child grows.
Early diagnosis and appropriate treatment of strabismus in children are of great importance for preventing permanent visual impairments. Therefore, it is recommended that parents have their children’s eye health checked regularly.
Strabismus in Infants
Strabismus in infants is an eye alignment problem noticed in the first few months after birth. It is generally caused by eye muscle weakness, genetic factors, or developmental issues related to premature birth. If not diagnosed early, strabismus can lead to permanent problems such as amblyopia (lazy eye). For this reason, it is important for parents to regularly monitor their baby’s eye movements and to consult an ophthalmologist in case of any suspicion.
How is Strabismus Detected in Infants?
Strabismus in infants can be treated effectively if it is detected early. The signs of strabismus can be easily understood through careful observation by parents and some simple tests. Check-ups, especially within the first 6 months, are critical for preventing permanent eye problems.
Methods for Detecting Strabismus in Infants:
- Single Eye Occlusion Test: If a baby shows distress when one eye is covered, it could be a sign of amblyopia or strabismus.
- Monitoring of Eye Movements: Observe whether the baby’s eyes move in parallel while tracking an object.
- Home Strabismus Test: Parents can assess whether there is an eye turn by observing the baby’s ability to focus on a point.
Strabismus Test
A strabismus test offers the chance for early intervention by detecting eye alignment problems. While parents can notice the signs of strabismus by applying simple tests at home, ophthalmologists make a definitive diagnosis with various clinical tests. Here are detailed explanations about strabismus tests:
Home Screening Methods for Strabismus
- Single Eye Occlusion Test: A baby’s fussiness when one eye is covered may indicate amblyopia or strabismus.
- Monitoring of Eye Movements: It is observed whether the baby’s eyes move in parallel while tracking an object.
- Focusing on a Point Test: The baby’s ability to focus on an object at different distances is evaluated.
Clinical Diagnostic Tests for Strabismus
- Hirschberg Test (Corneal Light Reflex Test): A light is shone into the eyes, and the corneal reflections are observed. The symmetry of the reflection in the eyes indicates whether there is a sign of strabismus.
- Cover Test: The movements of one eye are observed while the other is covered. This test is important for detecting conditions like latent strabismus (phoria).
- Visual Acuity Test: This test, conducted with symbols or letters for children, is used for the early diagnosis of vision problems.
Strabismus Surgery
Strabismus surgery corrects the alignment of the eye muscles, enabling the eyes to focus on the same point. This surgical intervention helps to alleviate symptoms caused by strabismus, such as abnormal head posture, double vision, and eye strain.
Types of Strabismus Surgery:
- Rectus Muscle Surgery: Achieves alignment by adjusting the length of the eye muscles.
- Adjustable Suture Technique: Allows for minor adjustments to be made in the early postoperative period.
- Botulinum Toxin Injection: Used as a temporary solution in mild cases of strabismus.
Risks of Strabismus Surgery
As with any surgical procedure, strabismus surgery has some risks. Complications such as infection, bleeding, and temporary double vision can occur, although they are rare. Being aware of these risks and having a detailed preoperative evaluation is important in preventing potential complications.
- Infection: Failure to adhere to hygiene rules after surgery can lead to infection.
- Bleeding: A rare but potentially serious complication after surgery.
- Recurrence: There is a risk that the strabismus may return.
- Double Vision (Diplopia): May occur temporarily and usually resolves in a short time.
After Strabismus Surgery
The recovery process after surgery can vary depending on the patient’s general health and the surgical technique applied. Mild pain, redness, and watering are generally considered normal in the first few days. The regular use of prescribed eye drops and adherence to hygiene rules will speed up the healing process.
- Mild pain, redness, and watering are normal in the first few days.
- Eye drops should be used regularly, and prescribed medications should not be missed.
- Strenuous exercises and activities that strain the eyes should be avoided for the first few weeks.
- Full recovery generally takes between 2 to 4 weeks.
Home Treatment for Strabismus
Strabismus is a condition that arises from the inability of the eyes to maintain parallel alignment, and its treatment varies depending on the type and severity of the strabismus. Some eye exercises that can be performed at home can play a supportive role by strengthening the eye muscles, especially in mild cases and for certain types of strabismus. However, it is essential to consult an ophthalmologist before starting these exercises.
Strabismus Exercises That Can Be Performed at Home:
- Pencil Push-up Exercise: Hold a pencil at arm’s length and focus on its tip. Slowly bring the pencil toward your nose, keeping your eyes focused on the tip. Stop when the pencil appears double and return to the starting position. Repeat this exercise 10-15 times a day.
- Brock String Exercise: String three beads of different colors on a string approximately 5 meters long. Tie one end of the string to a fixed point and hold the other end under your nose. Focus on the beads in sequence, trying to see each one clearly and singly. This exercise helps to improve eye teaming and focusing ability.
- Eyelid Exercise: Close your eyes tightly and hold for 2-3 seconds. Then open your eyes and keep them open for a few seconds. Repeat this process 10 times. This exercise can strengthen the eye muscles and reduce eye strain.
Important Warnings About Strabismus Exercises:
- Eye exercises may not be suitable for every patient and may not yield effective results in some cases. It is important to determine the appropriate treatment plan by consulting an ophthalmologist before starting the exercises.
- If any discomfort or pain is felt during the exercises, the practice should be discontinued, and a specialist ophthalmologist should be contacted.
Remember, strabismus treatment is individual and can differ for each patient. Therefore, treatment should not be started without a professional evaluation and guidance.
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