home Auditorium 7 Convergent strabismus - treatment and diagnosis. What is convergent strabismus in children and why is it dangerous? According to the nature of the affected visual organs

Convergent strabismus - treatment and diagnosis. What is convergent strabismus in children and why is it dangerous? According to the nature of the affected visual organs

Convergent strabismus (esotropia) is a form of strabismus (strabismus or heterotropia), in which the patient's gaze converges in the direction of the bridge of the nose. With this condition, a person is unable to focus on the object in question with both eyes at the same time, that is, he lacks binocular vision. In addition, convergent strabismus typically affects only one eye.

Esotropia is quite common and can develop at any age, but according to statistical data, convergent strabismus is most often observed in children.

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Differs in the following characteristics:

fact of development;
the nature of damage to the organs of vision;
principle of manifestation;
manifestation time.

Fact of development

Based on this factor, the disease can be divided into:

Congenital

As a rule, the congenital form appears immediately after birth and before six months of age.

It is worth paying attention to the fact that a child tends to develop a mild form of strabismus from birth. It manifests itself in the form of uncontrolled movements of the eyeballs. This is due to the fact that the baby’s eye muscles have not yet developed. Be sure to read the article about it on our website.

To understand whether the disease is really developing or whether it is due to weakness of the eye muscles and their lack of elasticity, it is necessary to show the child to a specialist.

Acquired

This type of pathology is more common in children aged two to three years. All causes of strabismus are associated with impaired vision.

Nature of the lesion

Depending on this factor, the disease is divided into two main types:

Friendly;
Paralytic.

Friendly

This type of disease is characterized by the fact that the eyes retain their full range of movements, the development of diplopia is not observed, but is absent.

Concomitant convergent strabismus is divided according to the involvement of the eyes into:

Monocular. This type of disease is characterized by the functioning of only one eye. With further development, amblyopia appears and progresses;
Alternating. Convergent alternating strabismus is characterized by a situation in which there is a deviation from the symmetrical location of first one of the eyeballs and then the other. In this case, an alternating shift is observed. This type is also characterized by the possible development of amblyopia while maintaining visual acuity.

Paralytic

This type has one distinctive feature - the movement of the affected eye has a limited range, that is, it can move in any direction except where the affected eye muscle is located. In this case, the eye squints in the opposite direction from the affected extraocular muscle.

Mechanism of occurrence

According to this factor, strabismus is divided into:

Refractive

This type of pathology is observed from an early age and is characterized by the beginning of a deterioration in accommodative ability. The disease can occur periodically and is most often easily cured.

Non-refractive

A disease of this type develops, as a rule, in patients with an already restructured visual system and the cause of the pathology is not a deterioration in visual acuity. If this type of strabismus progresses, it can become chronic. The duration of treatment will increase.

Development time

If we consider the pathology according to the time of manifestation, strabismus can be:

Impermanent

Due to its specific development, unstable strabismus can be treated quite easily. This form appears due to stress or diseases of the central nervous system.

Permanent

Permanent strabismus of a converging form is provoked by many factors, but, unlike the previous type, it differs in that the elimination of factors in the development of the disease does not lead to its disappearance.

A patient with persistent convergent strabismus requires competent and timely diagnosis, as well as individual treatment.

Hidden strabismus

In addition to the types listed above, there is a form close to pathology - heterophoria or, as it is commonly called, hidden strabismus. The true form differs from heterophoria in the absence of binocular vision in the patient.

Treatment for the appearance of this type of visual dysfunction is not required. Be sure to read the article about it on our website.

Causes of convergent strabismus

As you already know, the convergent form comes in a large number of varieties. The reasons contributing to the development of the converging type of heterotropy can be combined into two large groups:

congenital;
acquired.

The main factors that may cause the development of the disease are:

Impaired refractive ability of the visual organs in the form,.
Damage to the eye muscles (paralysis, paresis).
Diseases associated with the functioning of the central nervous system.
Abnormal processes during the formation of the organs of the visual apparatus in the prenatal state.
Physical injuries to the head and eyes, characterized by severe consequences.
Frequent stress.
Infection with infectious diseases.
Mental trauma.

Symptoms

The main signs that indicate the development of a convergent type:

it is impossible to focus both eyes on one object;
there are uncoordinated eye movements;
one of the eyes squints or closes involuntarily when a bright light source appears in the visual field (amblyopia);
you often need to tilt your head to look at an object;
frequent falls or collisions with surrounding objects;
frequent complaints about blurred vision before the eyes;
the eyes are constantly in a tense state;
fear of light or double vision of objects develops.

These symptoms may appear periodically, therefore, when they are first detected, you should consult your doctor for diagnosis and determine the appropriate treatment method.

Diagnostics

In order to determine whether a patient has strabismus and to determine its form, it is necessary to conduct a series of examinations to diagnose the disease. Diagnostics takes place in several stages:

conducting testing;
research of biometric indicators;
examination of ocular structures;
refractive ability test.

During the diagnosis, an anamnesis is collected. The doctor reconstructs the history of the progression of the disease. The patient tells the doctor when the first signs of strabismus appeared and what injuries were received over the entire period.

During an external examination, an examination is carried out:

eyeballs;
head and eye position;
facial symmetry is assessed;
the angle of strabismus is determined.

Subsequently, ophthalmologists use various methods to check visual acuity (the Golovin-Sivtsev table is most often used).

To identify convergent strabismus of a concomitant type, the following is often used:

computer refractometry;
biomicroscopy;
ophthalmoscopy.

Computer refractometry

If the patient is diagnosed with paralytic strabismus, then a consultation with a neurologist and the necessary neurological examination are required.

Treatment of convergent strabismus

In order to cure convergent strabismus, there are three main methods that are used depending on the degree of development of the disease:

Non-drug method

It involves restoring visual acuity with the help of glasses or contact lenses, special prisms, for example, Fresnel prisms.

Also, for strabismus that occurs in childhood, direct occlusion is used. This method of curing the disease is based on wearing a bandage that covers the field of vision of the healthy eye, thereby enabling the affected eye to work. The first results when using this method usually appear after six months of use.

Thanks to the use of special equipment, for example, a monobinoscope, a synoptophore, amblyopia and double image are eliminated.

Medication method

This treatment method involves the use of medications and special preparations.

Using eye drops, the doctor increases the stress on the affected eye, and this, in turn, activates it.

Surgical method

Surgical intervention is performed only when non-medicinal and medicinal methods, when carried out periodically, have not given the required result.

The main goal of the surgical operation is to strengthen or weaken one of the extraocular muscles; for this purpose, several operations are performed on each eye with a break of at least six months.

Operations that can cure strabismus can be performed only after 3-4 years, because before this age the development and formation of binocular vision occurs. An exception is a disease with a large angle of strabismus.

Prevention

The possibility of pathology occurring cannot be completely excluded, but this risk can be reduced to a minimum by following some rules:

observe the rules of visual hygiene;
avoid stressful situations;
Periodically visit your doctor to check your eye health;
Avoid situations that could lead to serious injury.

By following these rules, a person will reduce the risk of disease to a minimum.

In the case of strabismus, the system fails because the central nervous system (CNS) is forced to exclude information received by the affected eye.

The consequence of a long-term disconnection between the received and processed information is amblyopia, in which one eye actually does not take part in the visual process.

Sources of disease development

There are many types of strabismus, but they are all caused by the same reasons.

The basis for the development of the disease may be congenital or acquired characteristics:
Farsightedness, myopia;
Paralysis or paresis of the extraocular muscles;
Anomaly of development of visual organs;
Diseases of the central nervous system;
Severe physical injuries;
Severe stress;
Infectious diseases;
Mental trauma and much more.
Strabismus is easy to recognize visually, since there will be an unusual placement of the eyes relative to each other.

Convergent strabismus

It is one of the most common forms of the disease.

This is a pathology of the visual organs, in which one or both eyes begin to squint towards the nose. A person cannot focus on an object with both eyes at the same time.

There is a disease opposite to this - exotropia.

The affected eye is deviated to the outside.
Strabismus develops from childhood. In this case, excluding external factors, heredity or intrauterine diseases, as well as various childhood infectious diseases such as measles or scarlet fever, are most often blamed.

Convergent strabismus is an independent, autonomous disease with its own laws of development, in others it is a consequence or accompanying symptom of another, more serious disease - cerebral palsy, brain tumor or even Down syndrome.

Convergent strabismus in children under one year of age is normal. Just in case, you should show your child to a doctor, but you should not panic in this regard without confirmation from a specialist.

Types of convergent strabismus

In children, it can be divided into subtypes according to several criteria.

Based on the development

Congenital – manifests itself in the first six months of a baby’s life;
Acquired - mainly affects children aged two to three years.

According to the nature of the affected visual organs

1. Friendly:

Monocular – a situation in which only one eye functions incorrectly. The consequence is amblyopia;
Alternating convergent strabismus or alternating strabismus is a situation in which first one eye begins to squint, and then the other. Visual acuity is not lost, but amblyopia may develop.

2. Paralytic- the result of damage to the brain, oculomotor muscles that stimulate the functioning of the eye or nervous system.

According to the development mechanism

1. Refractive;
2. Non-refractive.

Concomitant convergent strabismus in children often begins at an early age. Patients face a periodic progression of the disease.

With timely intervention, vision can be normalized. If you ignore alarming signals, then in the process of restructuring the visual system, strabismus can become chronic and pronounced.

Permanent and intermittent strabismus

Non-permanent divergent strabismus in children, just like convergent strabismus, is easier to treat due to the specifics of its development.

The appearance of this disease is provoked by stressful situations. As soon as the events that have a traumatic effect on the baby’s psyche are completed, the strabismus gradually disappears.

The disease is a consequence of dysfunction of the central nervous system, but healing the nervous system guarantees the cure of strabismus.
Permanent squint in children requires competent and timely diagnosis, as well as individual treatment.

Some parents are misled by assurances that the disease will go away on its own with age, but this mistake can be fatal to the child’s vision.

Diagnosis of the disease

To make a final diagnosis of strabismus and determine its form, a comprehensive examination is carried out. It includes several stages:

Tests;
Biometric research;
Examination of the structure of the eye;
Refraction study.

At the diagnostic stage, an anamnesis is also collected, that is, the history of the course of the disease is recreated.

During the conversation, the ophthalmologist finds out the timing of the onset of the disease, and also studies information about all serious injuries received by the patient during his life.
The external inspection stage involves inspection of:

Eye;
Studying the position of the head and eyeballs;
Assessment of facial symmetry;
Strabismus angle.

After this, specialists use various methods to check visual acuity. To identify converging concomitant strabismus, the method of computer refractometry, biomicroscopy and ophthalmoscopy is also used.

If paralytic strabismus is detected, a consultation with a neurologist is required, as well as a neurological examination.

Treatment of strabismus

Depends on the characteristics of the disease.

Treatment methods:

Optical correction. This involves wearing glasses or soft contact lenses. Effective for refractive strabismus.
Surgical intervention. It is used for non-refractive and paralytic strabismus.
Development of binocular vision through application orthoptic and pleoptic treatment.
Treatment of amblyopia, that is, attempts to increase or maintain visual acuity, using hardware procedures.

Often only one eye undergoes surgery, but exceptions are possible. The operation is very quick and painless. The patient returns home the same day. After this, hardware treatment, orthoptic and pleoptic procedures are carried out, which help restore visual functions.

Igor Aznauryan
Pediatric ophthalmologist, academician of the Academy of Medical and Technical Sciences of the Russian Federation

Strabismus - this is a position of the eyes in which the visual axes do not converge on the object in question. Outwardly, this is manifested by the fact that the eye deviates in one direction or another (to the right or left, less often up or down, and various combined options are also found). If the eye is brought to the nose, strabismus called convergent (more common), and if towards the temple - divergent. One eye or both may squint. Most often, parents turn to a pediatric ophthalmologist after noticing that the child’s eyes are looking “wrong.”

Strabismus- This is not only a problem of appearance. Effect strabismus is a consequence of disturbances in perception and the conduction of visual information throughout the child’s visual system. At strabismus Visual acuity decreases, connections between the right and left eyes are disrupted, as well as the correct balance between the muscles that move the eyes in different directions. In addition, the ability for three-dimensional visual perception is impaired.

Strabismus may be congenital, but more often it occurs in early childhood. If the pathology appears before 1 year of age, then it is called early acquired. The disease may also appear at 6 years of age. But more often strabismus develops between the ages of 1 and 3 years. At birth, the child does not yet know how to look with “two eyes”; the ability to binocular vision develops gradually until the age of 4 years. In this case, any deviation of the visual axis from the point of fixation must be qualified as strabismus and under no circumstances should it be considered as a variant of the norm. This applies even to such seemingly cosmetically less pronounced cases as strabismus with a small angle and unstable strabismus.

Most often, strabismus develops in children with farsightedness– when the baby has difficulty seeing objects that are nearby. Strabismus may also develop in children with astigmatism. At astigmatism Some areas of the image may be focused on the retina, others behind or in front of it (there are also more complex cases). As a result, a person sees a distorted image. You can get an idea of this by looking at your reflection in an oval teaspoon. The same distorted image is formed with astigmatism on the retina. But although the picture itself with astigmatism may be blurry and indistinct, a person is usually not aware of this distortion, since the brain “corrects” his perception. Strabismus may also occur with myopia– when a child has difficulty seeing objects located at a distance.

At strabismus in a constantly squinting eye, visual acuity gradually decreases - amblyopia. This complication is due to the fact that the visual system, in order to avoid chaos, blocks the transmission to the brain of the image of the object that the squinting eye perceives. This condition leads to an even greater deviation of this eye, i.e. strabismus intensifies. The process of vision loss depends on the age of onset of the pathology. If this happened in early childhood, in the first year of life, then the decrease in visual acuity can be very, very rapid.

Reasons The occurrence of strabismus can be:

hereditary predisposition, when close relatives (parents, uncles, aunts, etc.) have the disease;
the presence of one or another optical defect (defocusing) of the child’s organ of vision, for example, with farsightedness in children;
various intoxications (poisonings) of the fetus during pregnancy;
severe infectious diseases of the child (for example, scarlet fever, diphtheria, etc.);
neurological diseases.

In addition, the impetus for the emergence strabismus(against the background of prerequisites) may be high temperature (over 38 ° C), physical or mental trauma.

Treatment

There are more than 20 different types of strabismus. Outwardly, all of them are manifested by deviation of the visual axis from the point of fixation, but in their causative factors and development mechanism, as well as in the depth of the disturbances, they differ greatly from each other. Each type strabismus requires an individual approach.

Unfortunately, even among doctors there is an opinion that before the age of 6 a child with squint you don’t need to do anything and everything will go away on its own. This is the greatest misconception. Any deviation of the eye at any age should be considered the beginning of the disease. If no measures are taken, loss of visual acuity may occur, and then treatment will require much more effort and time, and in some cases the changes become irreversible.

Sometimes strabismus It can be imaginary: due to the wide bridge of the newborn’s nose, parents suspect the presence of this visual defect, but in fact it does not exist - it is just an illusion. In newborns, the eyes are set very close, and the bridge of the nose, due to the peculiarity of their facial skeleton, is wide. As the facial skeleton develops, the distance between the eyes increases and the width of the bridge of the nose decreases. It is precisely in this case that everything really goes away with age and there is no need to correct anything, but to determine whether it is imaginary strabismus or real, only a doctor can. Any suspicion of a deviation from the norm should alert parents and prompt them to visit a pediatric ophthalmologist as soon as possible.

Timing of preventive visits to an ophthalmologist in the first year of a child’s life. The first examination is advisable immediately after birth. It must be said that in maternity hospitals, all babies without exception are not examined by an ophthalmologist. A neonatologist at the maternity hospital or a local pediatrician may classify the baby as a risk group, and then he will be prescribed a consultation with an ophthalmologist already in the maternity hospital or immediately after discharge. The risk group includes children with a family history of eye diseases (if their parents have any), premature newborns, children born during abnormal births, as well as children whose parents have bad habits (alcoholism, smoking). Further, an examination by an ophthalmologist is necessary for the baby at the age of two months, at six months and at the age of one year. During this time, all children are referred to an ophthalmologist.

The specialist will identify the presence or absence of farsightedness (myopia) in the child, the acuity and nature of vision, the angle strabismus and, if necessary, refer you for consultation to other specialists, for example to a neurologist.

Only after a thorough examination can complex treatment be started strabismus, including conservative therapy And surgery. The conservative part of treatment includes methods aimed at increasing visual acuity. If there is farsightedness or nearsightedness, according to indications, the child needs glasses. Sometimes they fix it completely strabismus. However, wearing glasses alone is not enough. It is very important to teach your child to combine images from the right and left eyes into one image. This is achieved through a set of therapeutic measures conducted in courses several times a year. The treatment is conservative and takes place in a playful way. In addition, the occlusion method is used - covering the good eye with a bandage for a certain time every day, so that the child learns to rely more on the weak eye.

It should be especially noted that the success of treatment strabismus depends on correctly selected individual treatment tactics. The treatment complex often involves the use of both conservative and, in most cases, surgical treatment. At the same time, surgery should not be treated as an alternative to conservative treatment. Surgery is one of the stages of treatment, the place and time of which depend on the type strabismus and the depth of damage to the visual system.

Before and after surgical treatment, conservative therapeutic measures should be carried out aimed at increasing visual acuity, to restore communication between the eyes and stereoscopic three-dimensional visual perception - this is achieved with the help of special exercises. Techniques are used to improve the functional state of the visual part of the cerebral cortex, to force the visual cells of the cortex to work in normal mode and thereby ensure correct and clear visual perception. These techniques are stimulating in nature. Classes are conducted using special devices on an outpatient basis in courses of 2–3 weeks several times a year.

During treatment, at a certain stage, in the presence of high visual acuity, restoration of the ability to merge two images from the left and right eyes into a single visual image, in the presence of eye deviation, surgical intervention on the muscles of the eye. The operation is aimed at restoring the correct balance between the muscles that move the eyeballs (oculomotor muscles). It is important to understand that surgery does not replace therapeutic techniques, but solves a specific problem that cannot be solved conservatively.

To decide the timing of surgical intervention, it is important that the patient has sufficient visual acuity. The sooner you put your eyes in a symmetrical position with direct gaze, the better. There are no special age restrictions. With congenital strabismus it is important to complete the surgical stage no later than 3 years, in case of acquired - depending on the timing of achieving good visual acuity at the conservative stage of treatment and restoration of the potential ability to merge images from both eyes into a single visual image.

Surgical treatment tactics are developed depending on the type strabismus. From a surgical point of view, treatment of a permanent form strabismus with a large angle strabismus when the eye is significantly deviated, does not present much difficulty. The effect of such operations is obvious to the patient. But for surgeons with certain qualifications it will not be difficult. Difficult to operate strabismus with variable and small angles. Currently, technologies have been developed for making an incision without the use of a cutting device (scissors, scalpel, laser beams). The tissues are not cut, but rather moved apart by a high-frequency stream of radio waves, providing bloodless exposure of the surgical field.

Technique of operations for strabismus microsurgical, general anesthesia with specific anesthesia is used, which allows you to completely relax the oculomotor muscles. Depending on the volume of the operation, its duration ranges from 20 minutes to one and a half hours. The child is discharged home on the second day after surgery. In the absence of a vertical component (when the eye is not displaced upward or downward), one or two operations are usually performed on one and the other eye, depending on the size of the eyeball and the type of strabismus. The sooner a symmetrical position of the eye is achieved, the more favorable the prospect of cure.

To school child with squint must be rehabilitated as much as possible. If you deal with the problem strabismus comprehensively, cure occurs in 97% of cases.

Thanks to a timely treated disease, the child can study normally, get rid of psychological problems due to visual defects, and subsequently do what he loves.

Strabismus or strabismus is a pathology in which the eyes move uncoordinated and are in an asymmetrical position. Incorrect position of the eyeballs does not allow the optical axes to converge when viewing objects, which leads to visual impairment. When the eyes look to the sides, and when converging they are turned towards the nose. It is noteworthy that convergent strabismus can be observed only in one eye, or alternately.

Types of convergent strabismus

Monocular convergent strabismus, when the defect affects only one eye. Monocular strabismus is often combined with (syndrome). The complication is due to the fact that with strabismus, the activity of the eye decreases and visual acuity decreases. The brain receives different information from the eyes, so it turns off the patient to eliminate discomfort.
Right-handed or left-handed alternating. This type of convergent strabismus is also called alternating. The defect is observed in both eyes, but at different periods. With alternating strabismus, amblyopia also develops, but to a lesser extent, since the eyes work in approximately the same mode. Visual acuity, as a rule, does not decrease.
Paralytic convergent strabismus. This type of strabismus develops when there is atrophy of the extraocular muscles, optic nerves or brain.

Concomitant convergent strabismus is diagnosed mainly in children. It must be remembered that the functionality of the visual system can only be restored until the age of 25, when the body is still developing. The best results are observed with early treatment of strabismus.

Causes of strabismus

The exact causes of strabismus are unknown. Pathology can be congenital or acquired. Congenital strabismus, as a rule, manifests itself already in the first six months of life. Since it is not possible to accurately establish a diagnosis during this period, it is recommended to monitor the patient.

Acquired strabismus occurs early, that is, it occurs in the first year of a child’s life. However, most often the causes of strabismus are diagnosed in children older than 2-3 years. It is generally accepted that heredity plays an important role in this process. Congenital strabismus is the result of intrauterine infections. A child may be born with a defect if the mother suffered severe intoxication during pregnancy.

Other causes of strabismus:

“childhood” diseases (scarlet fever, measles, colds);
underdevelopment of the oculomotor muscles;
pathologies of the muscles of the eyeball;
refractive errors (astigmatism, farsightedness, myopia).

Convergent strabismus can be an independent disease or a sign of another pathology. Eye defects occur with the development of tumors in the brain, Down syndrome, cerebral palsy, microcephaly, hydrocephalus, and congenital cataracts. Strabismus also appears with neuralgia and trauma, including psychological.

Examination for strabismus

It is noteworthy that most infants squint a little in the first six months of life. This is due to the peculiarities of the development of the visual system during this period. From time to time, the baby's eyes bunch up, reminiscent of the symptoms of convergent strabismus. There is no need to panic, but you still need to show your baby to an ophthalmologist.

When the child reaches six months, he should stop squinting his eyes. If symptoms continue, parents should address the issue and have the baby checked.

Examination methods for strabismus:

Interviewing parents if the patient is a child. The doctor must find out the suspected cause and period of occurrence of strabismus, the features of its development and concomitant eye diseases.
Determination of visual acuity (). It is important to evaluate the vision of each eye separately and both at once, as well as visual capabilities with and without correction.
Determination of the nature of strabismus.
Determination of the type of defect by direction.
Measuring the amount of deviation. For these purposes, the Hirshberg method is used: the patient looks at the mirror of a special device, and the ophthalmologist studies the light reflexes of the cornea.
Study of simultaneous and monocular vision.
Study of eye mobility. The disadvantage of this method is that it can only detect severe limitations in mobility.
Determination of fusion ability on.
Study of eye refraction using a skiascope.
Analysis of visual fixation (if vision deteriorates). The study can be carried out using a vizoscope and an ophthalmoscope.
Checking the optical environment (biomicroscopy, campimetry, ophthalmochromoscopy, photostress test). Sometimes strabismus develops due to anatomical changes in the eyeball.
Electrophysiological studies.
Determination of retinal visual acuity.

A child with strabismus may need additional consultation with a pediatrician, otolaryngologist, neurologist and other specialists.

Is it possible to cure convergent strabismus?

If the problem is identified in a timely manner, the treatment prognosis is favorable. It is recommended to treat strabismus until the age of 18-25, until the visual system is completely stabilized. It must be remembered that strabismus does not go away on its own, so the problem cannot be ignored. Without treatment, strabismus is complicated by amblyopia, decreased visual acuity, and even developmental delays.

Even if the course of strabismus goes without complications, the pathology constitutes a serious cosmetic defect that can greatly complicate the life of even an adult. Children with strabismus are often withdrawn and complex.

If you have strabismus, you cannot hold positions that require prolonged strain on the visual system. This includes control of transport and potentially dangerous equipment, rifle units of troops, etc. The pathology disrupts (the combination of images from different eyes into a single picture), which helps a person to see the three-dimensional world, correctly determine the distance between objects, perceive the physicality and depth of the environment.

A person with strabismus, who lacks binocular vision, cannot work with moving objects when it is necessary to instantly assess the depth of something. If you do not treat strabismus in a child, you can block his path to becoming a pilot, machinist, athletes, artist, surgeon, and even dentist.

How is convergent strabismus treated?

It is possible to cure convergent strabismus only with a combination of conservative treatment and hardware. Hardware treatment courses are carried out 3-4 times a year. This periodicity allows you to smoothly restore the connection between the eyes and teach the child to perceive a single image of the world around him. Sometimes surgical treatment of strabismus is required.

Methods for correcting strabismus:

Pleoptic therapy. Pleoptics studies methods of stimulating the macula of the retina. In case of strabismus, it is recommended to increase the load on the affected eye, so children are prescribed computer training and laser stimulation.
Orthoptic therapy. Orthoptics refers to ways to restore and improve binocular vision. Training takes place on a computer and weather forecasters.
Diploptic therapy. Techniques for restoring visual function using various lenses form part of orthoptics.
Convergence trainer. Exercises on this device help improve the functionality of the oculomotor muscles.
Spectacle correction.
Occlusion.

Goals of strabismus therapy:

Improved visual acuity. You can affect your vision by wearing a regular bandage on your healthy eye (glue,). The duration of therapy is determined by the doctor depending on the severity of the pathology. The patch helps block the healthy eye and activate the affected eye to train the extraocular muscles and prevent the brain from blocking it.
Establishing connections between the eyes. It is very important to achieve synchronous operation of the eyeballs.
Maintaining muscle balance. The muscles that move the eye can be restored to balance through surgery. This measure is not always implemented.
Improvement of stereoscopic and binocular vision. This stage is considered final, when there is already normal vision without glasses correction and the correct position of the eyes.

Surgical correction of strabismus is indicated only if conservative treatment fails. If after a year of treatment there is no improvement, it is necessary to evaluate the feasibility of surgery. Often surgical treatment is prescribed to eliminate a cosmetic defect. It must be remembered that surgery does not stop the treatment of strabismus. Vision restoration should continue even after surgery.

Conservative methods for eliminating strabismus

Treatment of strabismus is carried out in several stages. Each of them allows you to eliminate certain disorders and allow the visual system to develop normally. Often, for strabismus, glasses are prescribed for constant use. After three weeks, you can begin pleoptic therapy. At this stage, you need to level out the visual acuity in your eyes.

As part of pleoptic therapy, the doctor may suggest a technique for deteriorating vision in the healthy eye. This is necessary so that the patient can become more active. For these purposes, the patient is prescribed special drops for a healthy eye, which will depress vision. In parallel with this, you need to wear glasses in which the lens on the affected side will be strengthened.

The next stage of treatment is occlusion. The healthy eye is covered with a bandage to allow the patient to function at full capacity. Depending on the degree of strabismus, the bandage may be prescribed for one day or for several hours. In severe cases, occlusion must be carried out within a year. After occlusion, local illumination of the retina is shown. The method involves the use of special tools and apparatus.

When vision improves to the desired level, they move on to the next stage - orthoptic correction. During this period, the child is taught to merge images from different eyes into one. This can be done using devices with eyepieces and a computer. The child is asked to connect pictures of animals and other entertaining exercises.

The last stage of strabismus treatment will be diploptics. This is one of the most difficult steps, since it requires restoration of binocular vision. However, diploptic techniques are indicated only for strabismus up to 7 degrees.

Surgical correction of convergent strabismus

Correct eye position can be achieved through surgery. The operation is scheduled for a year or two, but only after amblyopia and refractive errors have been eliminated. The procedure involves correcting the position of the extraocular muscles.

For strabismus, three types of operations are performed:

weakening, which reduce the traction force;
enhancing;
changing the direction of muscle work.

The extraocular muscles can be weakened by recession, myectomy, and posterior fixation sutures. Recession involves moving the posterior insertion of a muscle closer to its origin. The procedure is carried out on all muscle groups of the eye (except for the superior oblique).

Myectomy consists of cutting off the muscle at the attachment site without subsequent connection. Most often, this technique is used to weaken the inferior oblique muscle, but the rectus muscles are rarely operated on. When using posterior fixation sutures, muscle strength is reduced without changing the attachment. Typically, this method is used to operate on the horizontal rectus muscles.

Enhancing operations:

Muscle resection. The operation is performed only on the rectus muscles.
Formation of a fold. The procedure allows you to strengthen the direction of the superior oblique muscle.
Moving. Performed after recession of the rectus muscle to increase its tension.

If the degree of pathology warrants surgery, doctors may recommend operating on the muscles of both eyes, even if the other is completely healthy, or just one when the problem seems to affect both. However, a decision about whether to operate on one or both eyes cannot be made based on visual assessment.

The specifics of the operation are determined depending on many factors. The doctor must understand whether the pathology worsens when viewing objects at different distances. If it gets worse, you need to assess the degree of deterioration when looking to the sides. It is also worth considering a history of ophthalmic surgery, especially intervention in the extraocular muscles.

Therapeutic exercises for strabismus

With convergent strabismus, the results of the main treatment can be improved with the help of special gymnastics. For exercise to be beneficial, you need to do it correctly and regularly. It is very important not to do gymnastics when you are tired.

The effect will be noticeable if you devote up to two hours a day to this (20-25 minutes several times). However, the exact time should be determined by the doctor depending on the severity of the strabismus.

Exercises to help correct the defect are quite simple. To train the eyes, plastic plates with holes of different shapes are used, through which the child must pull the cord. You can print out various shapes on a regular sheet of paper and ask your child to color in similar ones. To achieve the effect, it is enough to depict stars, balls, houses and other figures.

To treat strabismus, use a regular musical top. You need to unwind it and allow the child to examine and describe the emerging shapes. After a few months of home therapy, you need to see a doctor and check the results.

Unconventional methods for treating strabismus

For patients with strabismus, the news that the disease can be treated with chocolate is a pleasant surprise. The black type of sweet, which does not contain milk or filling, is considered healthy. Only chocolate with a large amount of cocoa will be effective for vision pathologies.

Sweets containing more than 40% sugar can be harmful. Before “sweet” treatment, you need to check the child’s allergic reaction. It is allowed to give the patient four pieces of chocolate for breakfast and lunch. Dark chocolate helps strengthen the eye muscles.

An additional measure for converging strabismus can be considered taking medicinal tinctures. At the initial stage of pathology development, rosehip infusion helps. To prepare the product, you need to pour boiling water over the berries and leave for 5-6 hours. Before use, the tincture must be filtered. It is allowed to add honey to improve the taste. For strabismus, it is recommended to drink a glass of tincture before each meal.

Traditional medicine suggests cabbage leaves to treat strabismus. The method is considered absolutely harmless. To prepare the product, boil several leaves of the plant and then turn them into a paste. Take 3-4 times a day.

It's no secret that currants have a beneficial effect on the visual system. When correcting strabismus, you can also use clover, pine needles, calamus root, and carrot juice. By regularly consuming cucumber or beet juice, you can prevent ophthalmic pathologies.

A healing effect is observed when using phytodrops. The simplest option is dill drops. To prepare them, just brew 10 g of greens in a glass of boiling water and strain thoroughly. For strabismus, drops are used three times a day. You can also use lotions with phytodrops made from apples, onions and honey. However, we must remember that honey is a strong allergen and is often contraindicated for children.

Prevention of strabismus

It is impossible to protect a child from strabismus 100%, but parents can minimize the risk by implementing prevention. The basis for preventing strabismus is visual hygiene. Toys can only be hung at a sufficient distance from the child’s eyes. You must constantly ensure that the baby does not get injured. It is important to avoid shocks and impacts.

If symptoms do not disappear when the child reaches six months of age, you should consult an experienced ophthalmologist. If symptoms of an infectious disease occur, you should consult a doctor and prescribe proper treatment, because often convergent strabismus becomes a complication of infection.

Children over three years old should be prohibited from squinting their eyes: during deliberate squinting, a muscle spasm occurs, which provokes a violation. It is necessary to protect the baby from fear and stress, as well as from certain types of games.

You need to start treatment for strabismus only with the permission of your pediatrician. You should make sure that the child has no contraindications from other body systems. This is especially true for herbal treatment, since children often develop allergies.