Strabismus in children: modern methods of effective correction. Strabismus in adults: causes and methods of treatment Cause of strabismus
Strabismus (strabismus, heterotropia) is an abnormal position of the eyes caused by dysfunction of the extraocular muscles, in which the eyes look in different directions.
Each eye focuses in one direction, but sends different images to the brain, which each person can easily verify by closing their right and left eyes alternately. In the cortical part of the visual analyzer, the brain combines images from both eyes, obtaining a single three-dimensional image - this is how binocular vision works normally. With strabismus, the eyes do not focus on one point, and the images are so different that the visual analyzer is not able to merge them into a single image.
With strabismus, the brain suppresses the image received by the unhealthy, squinting eye, and gradually the eye is completely turned off from the vision process. A condition called amblyopia develops, which manifests itself in an increasing decrease in vision due to suppression of eye function by the brain. An eye with suppressed function is called amblyopic, or “lazy.” This process develops quickly in the case of strabismus in children, since their brain adapts very quickly to changing conditions. Amblyopia is reversible if urgent and vigorous measures are taken, otherwise the eye may become completely blind and will not regain its functions.
In adults, amblyopia also develops when strabismus occurs, but much more slowly. Vision in the damaged eye decreases slowly, but due to defocus and the transmission of two too different images, a ghost effect occurs.
Causes of strabismus
Strabismus can be congenital or acquired. In the first case, the cause of strabismus is a hereditary predisposition, congenital abnormalities in the development of the extraocular muscles, or diseases of the mother during pregnancy.
Among the causes of acquired strabismus, diseases of the central nervous system are most often called; injuries, both physical and mental; deterioration of vision in one eye; past infectious diseases, which are a common cause of strabismus in children.
Types of strabismus
Strabismus is divided into two types: friendly and paralytic.
- Concomitant strabismus manifests itself equally when looking in all directions, it involves both eyes, and both deviate from the norm by the same distance. Concomitant strabismus develops in children much more often than in adults. The most common cause of strabismus in this case is progressive eye diseases.
- Paralytic strabismus is caused by paralysis of one of the extraocular muscles, resulting from a developmental abnormality, injury, disease of the nervous system or blood vessels. In this case, usually one eye is affected. Paralytic strabismus occurs equally often in children and adults.
According to the nature of the deviation, strabismus occurs:
- Convergent - the eye is directed towards the bridge of the nose
- Divergent - the eye is directed towards the temple
- Vertical - the eye is directed either down or up
- Mixed - combines the characteristics of several forms
According to the stability of manifestation, strabismus can be constant or periodic.
Symptoms of strabismus
The main symptom of strabismus is the appearance of the eyes, a visible squint. This is not always a reliable sign; for example, strabismus in children under one year of age is often imaginary. Imaginary strabismus is associated with the structural features of the palpebral fissures in young children, due to which the orbits turn outward, resulting in the impression of divergent strabismus. True strabismus in children under one year of age can be suspected when one eye is constantly deviated, showing signs of paralytic strabismus, but this may simply be caused by the fact that bright toys are always located only on one side of the crib.
In addition to the visible deviation of the position of one of the eyes, the symptoms of strabismus are a forced position of the head (constant tilt to one side or turn), which compensates for double vision, squinting, headaches and dizziness, as well as unilateral decreased vision.
Diagnosis of strabismus
Diagnosis of strabismus is carried out during a full ophthalmological examination; currently, special computer equipment is used for this. Binocular vision tests are carried out, deviation, refraction and mobility of the eyeballs in all directions are checked. If strabismus is diagnosed, a neurological examination is required.
Correction of strabismus in some cases is possible with therapeutic means, but the most radical and effective method is surgical treatment of strabismus. The choice of method depends on the cause of strabismus, as well as its type. Due to the risk of developing amblyopia and loss of vision in one eye, which will inevitably lead to deterioration of vision in the second, healthy eye, treatment for strabismus should be started as early as possible.
If the cause of strabismus is an eye disease (myopia, hypermetropia, astigmatism, etc.), it is necessary to treat this disease first. Often, correction of visual acuity and measures taken to eliminate amblyopia are sufficient to correct strabismus, especially strabismus in children, since in childhood the nervous system is extremely susceptible and easily restructured.
Optical correction involves wearing special glasses or lenses, gluing a healthy eye, which encourages activity in the impaired eyes, and special exercises that stimulate the proper functioning of “lazy” muscles. Corrective glasses can be successfully used even in cases of strabismus in children under one year of age. You need to know that non-surgical methods for treating strabismus require persistent, consistent and long-term use, over several months or even years.
In case of failure of conservative methods of correcting strabismus, as well as in some forms that are not subject to conservative correction, surgical treatment of strabismus is used. The type of surgical intervention is determined by the ophthalmologist depending on the nature of the strabismus disease. The operation itself is usually performed under local anesthesia; only for strabismus in children, general anesthesia is used. As a rule, the patient can be discharged on the day of surgery.
When treating strabismus after surgery, it is necessary to consolidate the result, and active measures to train the extraocular muscle are still necessary to prevent or eliminate existing amblyopia. Thus, to eliminate strabismus, surgical intervention alone is not enough; an integrated approach is required. With this approach, strabismus is quite amenable to correction.
Video from YouTube on the topic of the article:
Strabismus in children is a serious disease and many believe that it is completely impossible to cure. But that's not true! Nowadays, strabismus can be successfully treated. There are several fundamental points that parents need to know in order to completely rehabilitate their child, ridding him forever of such a problem as strabismus.
Strabismus in children must be treated! Moreover, modern ophthalmology has a large arsenal of safe and effective methods for correcting this problem. And vice versa - if strabismus in children is ignored, it will lead to serious visual impairment in the future.
Types of strabismus
Before finding out the intricacies of modern methods for correcting strabismus in children, it makes sense to figure out what kind of ailment it is. So, strabismus (otherwise known as strabismus or heterotropia) is any violation of the visual axes of both eyes, which normally should be parallel. The most obvious and obvious symptom of strabismus is an asymmetrical gaze.
In medicine, the following types of strabismus are distinguished:
- Horizontal strabismus. This is the most common type of strabismus. It can be converging (esotropia - when the eyes “slid” towards the bridge of the nose) or divergent (exotropia - when the eyes “gravitate” outwards, towards the outer corner).
- Vertical strabismus. Moreover, deviations can be both upward - hypertropia, and downwards - hypotropia).
In addition, strabismus is conventionally divided into monocular And alternating. In the first case, only one eye is always squinting, which the child practically does not use, which is why the vision of the squinting eye gradually decreases and dysbinocular amblyopia develops.
Alternating strabismus is distinguished by the fact that both eyes alternately squint (first one, then the other). And since both eyes (albeit periodically) are used, the deterioration of visual function, as a rule, occurs to a much milder extent than with monocular strabismus.
Strabismus in children: where is false and where is true?
Sometimes, when stroking babies up to 3-4 months old, it may seem as if their eyes are squinting. In fact, in most such cases, as a rule, there is no medical problem: the bevel occurs due to the structural features of the facial skull (due to a skin fold at the corner of the eye or the wide bridge of the nose). Several months will pass, and there will be no trace left of the former slight “squint.”
Meanwhile, to calm the parent’s soul, it is useful to conduct a series of special tests (the so-called differentiated diagnosis between false and true strabismus), which will certainly convince the baby’s parents that there is no problem. We can talk about true strabismus only when the ophthalmologist has identified certain oculomotor disorders in the child.
Even if visually, when looking at a baby, one gets the impression of slight strabismus, but there are clearly no oculomotor disorders, then this condition is not a pathology - it is called false strabismus, and does not require any therapeutic measures.
And since strabismus in children can be not only congenital, but also acquired (its symptoms usually appear in children under 3 years of age), examinations by an ophthalmologist must be periodic.
Show your child to a pediatric ophthalmologist regularly: preventive examinations should be carried out at 2, 6 and 12 months, once a year until the age of 6-7 years. If an eye pathology is detected, the pediatric ophthalmologist will prescribe an individual schedule of visits.
Causes of true strabismus in children
The reason for the development of strabismus is the inconsistency in the work of the two eyes, the impossibility of their working together.
Strabismus can be congenital or early acquired, and can appear between the ages of 1.5 and 3-4 years. The fact is that at this age the formation of finer structures of the visual system continues, and the final phase of the formation of binocular (that is, volumetric, stereoscopic) vision occurs.
The child grows up, begins to look at pictures, collect pyramids and construction sets, play educational games - his visual work begins and gradually increases. Therefore, it is during this period that there is a risk of strabismus, which increases significantly if the child has congenital farsightedness or anisometropia (in other words, a difference in refraction between the right and left eyes), neurological pathology (for example: cerebral palsy, Down syndrome).
On the other hand, any stress on the body can be a provoking factor for the appearance of strabismus in children: vaccination, viral disease, fear or shock, high temperature.
If parents do not begin treatment for the child in a timely manner, strabismus develops into a serious functional pathology. For example:
- a child with strabismus cannot merge images from both eyes into a single image - the brain turns off the squinting eye from the act of vision;
- a child with strabismus cannot perceive spatial volume, i.e. 3D format - he sees the world as flat.
In total, about 25 types of childhood strabismus are known in ophthalmology today, each of which requires a special, individual approach to treatment.
The task of a pediatric ophthalmologist is to determine the type of strabismus, the cause of its occurrence in the child and prescribe the child the treatment that he needs at that particular moment.
When is it necessary to treat strabismus?
If you are told that strabismus will go away on its own, or that treatment needs to be carried out when the child grows up, look for another ophthalmologist. This is the wrong approach. You will waste valuable time!
Treatment of strabismus in children should begin immediately from the moment of diagnosis and, best of all, in a specialized children's eye clinic. The first therapeutic measures are possible from the age of 5-6 months. At this age, the child can get his first glasses (if there are refractive errors). Modern frames are made of safe and durable materials and are absolutely safe for the baby!
How to treat strabismus
In order to completely rehabilitate a child and achieve results, it is necessary to carry out the correct comprehensive treatment, developed individually for the child. As a rule, the course of treatment includes the following activities:
- individual occlusion mode (special occlusions for the better seeing eye);
- correctly selected spectacle correction;
- a set of therapeutic techniques to improve visual acuity and develop binocular functions;
- if necessary, surgical intervention (in order to make the gaze symmetrical and even).
Strabismus in children: to operate or not?
The decision to perform an operation should be made only by a pediatric eye doctor who is treating the child based on the state of his visual functions.
In approximately 85% of cases of strabismus in children, regardless of its type and the cause of its occurrence, surgical intervention is justified and necessary.
The pediatric eye surgeon chooses the method of performing the surgical stage based on the type of strabismus and the specific case of imbalance between the extraocular muscles. Today, one of the most effective surgical techniques for correcting strabismus in children is considered to be the method of mathematical modeling of a future operation and the use of radio wave technologies.
When to have surgery to correct strabismus
A child’s visual system develops up to 3-4 years of age. It is during this period that it is important to ensure a completely symmetrical position of the eyes in a timely manner, so that the correct picture is in front of the eyes, so that the brain begins to correctly perceive the information received from the eyes. At an older age, this will be extremely difficult to do. That is why the operation must be performed up to 4 years, while the visual system is developing!
Is the operation dangerous?
Modern surgery has become precise and less traumatic. Including through the use of mathematical modeling of future operations and radio wave technologies.
The use of radio wave technologies ensures the most minimally traumatic operation and a reduction in rehabilitation time - after all, the operation is performed without incisions! After surgery to correct strabismus, the child is discharged from the hospital the very next day.
If a pediatric eye surgeon uses mathematical modeling of an operation, its accuracy is practically guaranteed, and he can show the planned result of the operation to the child’s parents even before the date of the operation is determined.
Using the mathematical modeling technique, even before surgery, the surgeon is able to show parents what the child’s eyes will look like immediately after correction. The photo shows an example of such modeling: on the left is the state before the operation, on the right is immediately after.
This illustration is taken from the working archive Igor Erikovich Aznauryan, Doctor of Medical Sciences, Academician of the Academy of Medical Sciences of the Russian Federation, pediatric eye surgeon, head of children's eye clinics "Yasny Vzor". This is a specific example of an individual calculation for correcting strabismus in a child using a mathematical modeling system for the operation.
It is important to understand that modern surgery is one of the important stages of complex treatment, which allows you to make your eyes look even. But in order to restore lost visual functions and completely rehabilitate a child, one operation, even a super-successful one, is not enough - full-fledged therapeutic treatment must also be carried out. Refusal to carry out complex treatment can lead to irreversible consequences - even after surgery, after some time and without proper therapy, the eye may begin to squint again.
It is important that parents understand that solving any eye pathology must be approached comprehensively. Including strabismus. Do not delay starting treatment - start correction in a timely manner. In this case, success will be guaranteed, and the result of treatment will be stable for life!
Many people wonder, how do people with strabismus see the world? Let's try to understand this interesting and not easy issue.
When communicating with a person, you can understand within the first three seconds that he is mowing. People who have strabismus are divided into 2 categories in relation to their defect: who do not care what others think about their appearance and who suffer from the fact that everyone is looking at their faces.
This is not just a cosmetic problem. Due to visual impairment, work capacity and quality of life are significantly limited, and in childhood there is irritability, self-doubt, and refusal to wear glasses. And despite the fact that technology is now at a high level, the percentage of people mowing is not decreasing. This is due to the predominance of a sedentary lifestyle, active use of the computer in everyday life and other factors.
Strabismus is considered a pathology when the eyes do not look in the same direction, as expected, but in different directions. The pathology can also be found under the name strabismus (deviation).
Normally, with a symmetrical position of the eyes, images of objects are projected onto the central parts of the retinas. In the brain, they merge into a single whole - binocular vision is formed, the ability to see stereoscopically (3D). One three-dimensional image is created with volume, depth, relief and precise localization of objects in space. This is why we see one image with both eyes.
With strabismus, image fusion does not occur, since images from objects do not fall on the symmetrical parts of the retinas. A person begins to see the doubleness of everything around him. The brain protests because the feeling of double vision is very uncomfortable and the squinting eye is excluded from the process of vision formation. If this condition continues for a long time, amblyopia, or simply lazy eye, develops.
With strabismus, vision is monocular, people are deprived of the opportunity to see stereoscopically, in depth and fully.
Having seen deviations of the eyeball, first of all you need to find out what type of strabismus is occurring: real, hidden, imaginary strabismus.
Imaginary or false strabismus is observed in healthy individuals, with facial asymmetry, wide epicanthus (a fold of skin in the area of the inner corner of the eye) and other factors. The person's vision is not affected.
Hidden strabismus- this is a deviation of the eye under conditions that exclude the fusion of images from both retinas. For example, if you cover your eye with an opaque screen for 10-15 seconds, and then remove it and watch the movement of the eyeball, you can see how the latter changes its position - it deviates and returns to its previous central position. This occurs through unequal force of action of the oculomotor muscles, but the binocular is not affected.
True strabismus is considered to be a pathology of the oculomotor system when there is a deviation of one or both eyes alternately when looking straight. This type is the main problem of strabismus in ophthalmology. The main patients for this pathology are young children. And it is easier to correct strabismus in them than in adults.
Causes of strabismus varied and can be either congenital or acquired. Children are more likely to experience this disease. Pathology can occur with moderate and high refractive errors (myopia, farsightedness, astigmatism), as a result of injuries, stress, neurological problems (stroke, cerebral palsy, brain tumors, paresis and paralysis), infectious diseases (influenza, meningitis, measles), congenital features of the development of the oculomotor system, with inadequate visual load.
What do people with strabismus feel and how do they see?
A patient suffering from strabismus may complain of double vision, fatigue when reading, frequent headaches and dizziness, and unilateral blurred vision. They squint and their head may be turned or tilted. Doubling of objects is not present in all cases.
By type of deviation:
- Convergent strabismus - the eyes are in a group, directed towards the bridge of the nose. The most common form. Predominant in people with farsightedness.
- Divergent strabismus - the eyes are apart, directed towards the temples. Predominant in individuals with myopia.
- Vertical - deviation of the eyeball up or down.
- Mixed - a combination of several previous types.
By origin:
- Concomitant strabismus - movements of the eyeballs are preserved in full. It manifests itself mainly in childhood around 4 years of age (critical moment) and is often unstable at the beginning.
- Paralytic strabismus - movements of the squinting eye are absent or limited; it is always an acquired and permanent form. Provokes a feeling of double objects.
By eye involvement:
- Unilateral - only one eye is involved in the process.
- Alternating (alterating) - either the right or the left eye is involved in the process of deviation from the visual axis.
Diagnosing strabismus is currently not difficult. You can find out everything about vision in every clinic, where a qualified doctor will confirm or refute this diagnosis after conducting a series of simple studies. One of the main tests for strabismus is a *vision test* for binocularity.
Treatment.
It should start as early as possible, even in childhood. The principles of eye treatment for strabismus include not only restoring the correct position of the eyes, but also correcting refractive errors and normalizing other visual functions.
It is carried out using glasses, soft contact lenses, special spectacle prismatic lenses. Laser vision correction, which is now popular, is also used. Hardware treatment, orthoptic and diploptic treatment, and surgical intervention are also used.
When amblyopia develops, closure of the healthy eye (called penalization) is prescribed by sealing the corresponding spectacle lens or eye socket. This is done in order to give a load to the weakened muscles of the squinting eye. Such “training” should be carried out over a long period of time and constantly monitored by a medical specialist. Under the influence of constant stress on the “lazy” eye, vision is restored.
Surgery is performed in most cases to eliminate a cosmetic facial defect. It does not have any special therapeutic effect. Indications are paralytic and concomitant strabismus, if pleoptoorthoptic, that is, conservative treatment does not bring the expected effect.
Improving vision and restoring it- the process is long and can take 2-3 years, so owners of an unpleasant illness need to be patient and persevering in order to bring the matter to a positive end. And if we consider that the main patients of this disease are young children, then it is important for parents not to miss the critical moments of vision formation (3-4 years) and adhere to a healthy lifestyle. It is necessary to actively address the issue of curing their children, since such visual impairment is becoming less and less treatable every year. Do not mistakenly think that the child will grow up and the strabismus will go away on its own over time. Then it may be too late, amblyopia will occur, and no glasses, exercises, or surgeries will help restore one hundred percent vision. And adult children will ask, dad, mom, why didn’t you make every effort to eliminate my problem in childhood?
In order to prevent the development of an unpleasant illness, you need to maintain good work hygiene, do not overstrain your eyes, and with visual strain, give a rest for 10-15 minutes every 45 minutes. If your vision decreases, follow your doctor’s recommendations, wear glasses, and do exercises.
Children are not allowed hang toys close, watch TV all day, play computer games, spend a long time in front of the screen of a tablet or phone. You need to walk more in the fresh air, play physical games, get stronger, and generally lead a healthy lifestyle. By following simple recommendations, you can avoid this eye disease. Finding out everything about vision and how to save it is not difficult if you have the Internet.
Recently, cases of strabismus have become more frequent, especially in children. If in infancy the defect does not look repulsive, but on the contrary looks funny, then in older years there is every reason to get rid of the disease. It is unpleasant not only from an aesthetic point of view, but also from a medical point of view. Doctors strongly recommend getting rid of congenital strabismus as quickly as possible. It is much easier to get rid of pathology in infancy, especially with timely treatment. Congenital strabismus causes a child many problems, he experiences discomfort not only in terms of psychological and emotional pressure, the diseased eye can completely fail and be uncontrollable if treatment is not taken on time.
It is easy to determine the pathology thanks to the characteristic signs. For treatment today there are many methods, ranging from conservative ones - wearing corrective glasses, performing exercises for the visual organs; and ending with surgical intervention and surgical “leveling” of the diseased eye. Usually, surgery is resorted to when other methods of treatment are powerless; there are also several characteristic types of pathology for which surgery cannot be avoided.
Note! According to statistics, 1 in 50 children suffers from strabismus. This is one of the most common childhood eye diseases. In terms of prevalence, this pathology can be equated to myopia, which also often occurs in childhood.
Pathology is formed due to inconsistency in the work of the eye muscles. With normal functionality of these muscles, the eye focuses on a specific object. And with strabismus, one eye loses focus due to muscle weakness. The brain receives different information from both organs of vision, as a result of which the nervous system cannot create a three-dimensional image. The affected eye does not participate in the visual process at all. Over time, he stops “working” and begins to mow. This pathology in children is also called “lazy eyes”.
Why does strabismus occur? Six muscles are responsible for moving and focusing the eye. If at least one of them is affected, the child begins to develop strabismus. There are many reasons for the appearance of pathology. They depend primarily on the type of strabismus, which can be congenital or acquired. Let us consider in more detail the features of the appearance of congenital strabismus.
Causes of congenital strabismus
Unlike acquired strabismus, congenital strabismus is quite rare. Its appearance at birth is due to the following reasons:
- genetic predisposition;
- birth defects (Down syndrome);
- transmitted from parents if both suffered strabismus;
- improper carrying of the child;
- untimely birth;
- maternal use of drugs and alcohol, smoking during pregnancy;
Note! Muscle tissue can also be damaged at birth if the mother, while carrying the child, suffered from certain infections, including measles and ARVI.
These and many other reasons can cause the disease to appear in the womb. A child may be born immediately with severe strabismus. It needs to be treated as early as possible, otherwise it will lead to complications.
Pathology is divided into two types: friendly and unfriendly strabismus.
Friendly means equal magnitude of deflection angles. That is, in this case, the functioning of the eye muscles is incorrect, but mobility is maintained, which means that the child does not see a double image.
In addition to this pathology, a child may develop other diseases against its background. Among them are myopia, farsightedness and others, this happens if it is not done in time. It is possible to restore vision with corrective glasses.
Strabismus at birth can be caused by muscle paralysis. In this case, it is impossible to cure the pathology with correction glasses; only surgical intervention will help.
The organ of vision can squint either to the side, or up or down. Strabismus also happens. There are also mixed types. Often, pathology affects visual acuity: the affected eye may begin to see poorly over time. There is a type of strabismus when the eyes squint with a certain frequency. This indicates a disruption in the proper functioning of the nervous system. The disease may appear again after complete correction with glasses - this is secondary strabismus. There is a type of pathology when the direction of the eyes changes when looking into the distance.
Heterotropia is divided according to the degree of severity depending on the angle at which the eye squints. There is obvious strabismus, moderate and less noticeable.
Unfriendly strabismus. In this case, there is a mismatch of angles, as a result of which eye mobility in one direction or another is lost. Typically, strabismus at birth is of this type. A child is born with a complete or partial lack of eye mobility. The reason for this phenomenon is genetic predisposition and developmental abnormalities. Sometimes this type of strabismus is affected by damage to the nerves responsible for eye movement.
In addition to true strabismus, young children may develop so-called squint. This means that the baby has not yet learned to focus on objects. There is no cause for concern, since the imaginary strabismus disappears over time. But it’s better to get examined by a doctor.
Such imaginary strabismus can be found not only in children, but also in people in a state of alcoholic intoxication, when it seems that their eyes are squinting.
Treatment of congenital strabismus
At birth it is not immediately noticeable, whereas in an adult the pathology is visible to the naked eye. If parents notice any deviations from the normal functioning of the eyes, the baby is shown to the doctor. He identifies pathology and, depending on this, he prescribes effective treatment.
The correct position of the eye is restored, it must correspond to the direction of the neighboring eye and be stably placed. Treatment should be carried out systematically and intensively if strabismus appeared immediately at birth. The best way to restore vision in this case is to wear corrective glasses. However, prescribing glasses for complete treatment is not enough; there must be a systematic approach to recovery.
In addition to constantly wearing glasses, therapeutic corrective exercises for the eyes should be carried out. You need to prescribe glasses as early as possible, this will increase the chances of getting rid of the pathology. Usually, by the 8th month of life, corrective glasses are allowed to be worn. This treatment method prevents the development of accommodative strabismus.
If a child is diagnosed with amblyopia, treatment should be started immediately. It consists of restoring the eyeball of the diseased eye by closing the healthy one. An eye that sees well can remain in a closed position for many months until the diseased organ of vision is in the correct position. You should periodically check your vision, monitor the progress of treatment and the condition of both eyes.
So, to restore vision, various methods are used: eye exercises, correction with glasses. For children, play activities are effective for developing correct eye position. Depending on age, some active types of exercises are selected. For example, children play with soft parts, make them up, take them apart and sort them. Effective drawing, tracing, cutting out paper, working with plasticine. Children are taught to read very small letters so that their eyes can focus on them.
Note! These correction methods can help to at least partially restore vision. However, if they do not produce results at all, the only treatment left is surgical treatment.
Surgical treatment cannot be performed in infancy. You can go under the surgeon’s knife only at the age of three years. After the operation, you must continue to work on restoring your eyes, performing strengthening exercises and games presented above.
You need to be patient, because it may take years to completely get rid of strabismus. But only long-term complex treatment will help you forget about the pathology once and for all. The speed of recovery depends on the age of the child, the type of pathology, and also on how long the child has suffered from strabismus. The course of treatment is influenced by the child’s visual acuity, general health, as well as the method of treatment chosen.
Work with the eyes must be carried out in a complex manner. A pediatrician, an eye doctor, a teacher, and a psychologist should work with the child. Timely, regular treatment is the key to a quick recovery. Such a pathology is nothing to joke about; treatment cannot be neglected even in infancy, because in the future the disease will develop into more serious forms, and it will be much more difficult to get rid of it.
Use of medications
In addition to eye correction with glasses and exercises, medications are used in treatment for additional results. Medicines are selected that can restore the functionality of muscle tissue, reduce eye strain and improve vision.
Surgical intervention
This method of restoring the affected eye is used if conservative treatment does not help, as well as with some types of congenital strabismus: paralytic and non-accommodative. The essence of the treatment is to restore the functioning of the affected “failed” muscles. When the pathology manifests itself very strongly, sometimes not one, but several operations are used with intervals of six months.
Surgical intervention can be of two types:
One of two types of surgery is chosen depending on the type of pathology and the angle of the lesion. Sometimes a mixed operation is performed, using both methods of vision restoration at the same time.
As already mentioned, the optimal and safe age for eye surgery is from three years. However, with congenital strabismus, in especially severe cases, surgical treatment is carried out at an earlier age.
After surgery, treatment does not stop. The child is prescribed corrective glasses. For complete recovery, complex therapy is carried out, which is usually quite long.
Note! not cheap. You need to be prepared for big expenses. In Moscow, surgical intervention costs from 20 thousand rubles per eye. This is the initial cost; in severe cases of pathology, the price will be higher.
In addition to the costs of the operation, a lot will be spent on a long rehabilitation period, examinations and consultations with doctors.
Self-medication is strictly prohibited. At the first manifestations of strabismus, you need to consult an ophthalmologist in time. He will diagnose the pathology and choose the type of treatment. This is either restoration of vision using hardware, or referral for surgery. The doctor will give recommendations and tell you when it is best to start treatment so as not to harm the baby and speed up the recovery process as much as possible.
Strabismus can be cured in special eye centers, where there are all the conditions and equipment for this. Don't forget that strabismus is more dangerous in infancy. Despite the fact that such strabismus occurs in rare cases, its treatment still needs to be approached seriously and responsibly. Most often, the pathology is associated with muscle paralysis, and the only treatment is surgery. However, with timely and properly structured treatment and rehabilitation, it is quite possible to get rid of the defect forever.
Strabismus in children and adults is a disease characterized by a disorder of the visual process, in which the pupils are located on different axes in relation to something (they do not converge). Outwardly, this is noticeable by the location of the eyes - they can deviate in different directions. Childhood strabismus can have mixed features. This disorder can affect either one eye or both. But the problem of strabismus lies not only in external signs. This problem is the result of incorrect perception and transmission of visual images throughout the visual process system.
Usually, even in childhood, parents themselves notice the different positions of their child’s eyes. But it is possible to accurately determine this only at the age of four months, since from birth the baby is unable to correctly focus vision with both eyes. This ability appears only at the age of four months.
According to statistics, strabismus can begin to develop at three years of age and is manifested by a gradual deterioration in visual acuity. This visual disorder is less common in newborn babies, who can quickly lose their vision, because it is almost impossible to diagnose this disease at such an early age.
Strabismus affects the mental state and social life of a person. He becomes withdrawn, angry and irritable. In addition, there may be difficulties in choosing a profession. It is worth noting that such a problem can lead to complications such as vision loss in one eye. If strabismus is not treated in a timely manner, amblyopia and significant vision loss can occur in half of people with this diagnosis. It is possible to cure strabismus, but this process of correcting and restoring vision will take a lot of time and patience for the sick person.
Etiology
The causes of such eye problems are divided into congenital and acquired.
The first group of reasons include:
- genetic predisposition;
- unhealthy lifestyle of the expectant mother during pregnancy (use of alcohol, drugs or medications in large quantities);
- premature birth of a child;
- low baby weight at birth;
- congenital eye defects;
The second group includes:
- visual impairments such as – or ;
- stressful situations;
- stress on the eyes, in the form of prolonged exposure to light radiation;
- infectious diseases of varying severity;
- diseases accompanied by fever;
- accidents that lead to a sharp increase in body temperature.
But it is worth noting that for each person the reasons for the manifestation of such a visual disorder are purely individual.
Varieties
According to the time of manifestation, strabismus occurs:
- permanent;
- periodic.
By prevalence:
- one-sided;
- alternating, in which the problem passes from one eye to the other in turn.
In the direction of the eye:
- converging, in which the direction of the eye is directed towards the bridge of the nose;
- diverging - to the temple;
- vertical strabismus - the eyes are located up and down in relation to each other;
- mixed.
By the movement of the eyeballs:
- friendly, when their mobility is fully preserved;
- paralytic - in which the affected eye loses its ability to move. It can only be eliminated through surgery.
With hidden strabismus, the correct position of the eyes and focus on the object are noted. But as soon as one eye ceases to participate in the visual process, the process of latent strabismus begins in the second, in which the open eye involuntarily deviates to one side.
Symptoms
The main symptom of this disorder in children and adults is decreased vision clarity.
For children under seven years of age, characteristic signs of strabismus will be:
- problematic focusing of both eyes on one thing;
- turning or tilting the head when looking at something. This symptom is characteristic of paralytic strabismus;
- the child does not notice some objects while moving, which is why he bumps into them, hits them or gets injured;
- slight discrepancy in eye position when directly exposed to bright light;
- asynchronous movement of the eye sockets.
In children from the older age group and in adults, strabismus is manifested by the following uncomfortable sensations:
- rapid eye fatigue;
- blurred vision;
- frequent severe dizziness;
- increased sensitivity to light;
- the duality of objects when looking at them.
In newborn babies in the first months of life, the movement of both eyes is not connected with each other. But upon reaching the age of four months, this symptom disappears, and both eyes take the correct position.
Diagnostics
Parents themselves can diagnose strabismus in children with severe eye deviation. But in order to identify this disease in the early stages, you need to undergo a full examination by an ophthalmologist. During the examination, the doctor must draw up a complete picture of the course and expression of the disease. During the initial examination, the ophthalmologist should first assess the following indicators:
- head position (to determine paralytic strabismus);
- symmetry of the shape of the head with the shape of the eyes;
- location of the eyeballs.
Using specific techniques, it is determined:
- clarity of vision;
- eye divergence angle;
- possibility of hidden strabismus;
- mobility of gaze in relation to the subject;
- the presence of damage or problems in functioning throughout the visual system.
When diagnosing paralytic, alternating and divergent visual impairment, additional consultations with a neurologist are required.
After carrying out diagnostic measures, the doctor is obliged to inform the patient about how to get rid of strabismus, treat and prevent it.
Treatment
Treatment of strabismus in children and adults is aimed at normalizing the clarity of vision and the functioning of the visual apparatus as a whole.
Treatment of the disease is carried out in several ways:
- optical vision correction using special glasses or lenses;
- pleopto-orthoptic treatment, which is aimed at increasing the load on the eye damaged by strabismus. To do this, the healthy eye is excluded from the visual process for some time. Using special computer programs, the focus of both eyes is restored;
- Surgical intervention in the treatment of visual impairment is used after conservative treatment has failed. Surgeries are aimed at strengthening or weakening the working functions of the muscles that are responsible for moving the eyes. But such therapy may not give the expected effect, but on the contrary, only aggravate the situation. Complications after surgery may include bleeding, incomplete restoration of vision, infection or complete loss of vision;
- prescribing special gymnastics for the eyes.
The effectiveness of treatment is determined by the recovery:
- identical position of the eyes;
- stability of equal visual acuity in both eyes.
The best treatment results can be achieved with concomitant and divergent strabismus. Untimely and unprofessional treatment of strabismus in children and adults can lead to complete loss of vision.
Prevention
It is best to start preventing strabismus in childhood, so that the disease does not begin to progress in either the child or the adult. Preventive actions:
- regular examinations of the child by an ophthalmologist;
- organization of proper eye strain;
- maintaining personal hygiene;
- maintaining a healthy lifestyle during pregnancy;
- refusal of the expectant mother from alcohol and nicotine;
- Immediately seek medical help for skull injuries;
- daily eye exercises (using exercises).
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