Strabismus: Causes, Symptoms, Diagnosis, Treatment, and Prevention
The condition of strabismus is characterized by a misalignment of the eyes when looking at an object. It affects either one eye or both, and it can cause the eyes to turn inward, outward, upward, or downward. A child's strabismus may cause double vision, headaches, and eye strain, as well as affect vision, depth perception, and eye coordination. It is more common in children, but it can also occur in adults.
Causes of Strabismus
Strabismus can be caused by different factors, such as:
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Problems with the eye muscles, the nerves that control them, or the brain that coordinates them. These can be present at birth or develop later in life due to injury, disease, or aging.
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Uncorrected refractive errors, such as farsightedness, nearsightedness, or astigmatism. These can make the eyes work harder to focus, which can lead to eye fatigue and misalignment.
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Medical conditions, such as Down syndrome, cerebral palsy, hydrocephalus, brain tumor, diabetes, or thyroid disorders. These can affect the development or function of the eyes or the nervous system.
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Stroke or head injury. These can damage the brain or the nerves that control eye movement.
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Family history. Strabismus can run in families, especially if there is a history of farsightedness or accommodative esotropia (a type of strabismus that occurs when the eyes turn inward to focus on near objects).
Symptoms of Strabismus
The main symptom of strabismus is the misalignment of the eyes, which can be noticeable or subtle. Depending on the type and severity of strabismus, other symptoms may include:
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Double vision or blurred vision
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Poor depth perception or difficulty judging distances
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Difficulty reading or doing close work
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Frequent blinking or squinting
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Closing or covering one eye to see better
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Tilting or turning the head to improve vision
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Eye strain or headaches
Diagnosis of Strabismus
Strabismus can be diagnosed by an eye doctor (ophthalmologist or optometrist) who will perform a comprehensive eye exam. The exam may include:
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Checking the visual acuity (sharpness) of each eye
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Measuring the refractive error (prescription) of each eye
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Testing the eye alignment and coordination
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Examining the eye structures and movements
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Evaluating the health of the eyes and the nervous system
The eye doctor may also use special instruments, such as a prism or a cover test, to measure the degree and direction of the eye deviation.
Treatment of Strabismus
The treatment of strabismus depends on the cause, type, and severity of the condition. The main goals of treatment are to:
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Improve the alignment and coordination of the eyes
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Restore or preserve the vision in both eyes
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Prevent or treat amblyopia (lazy eye), which is a condition where one eye has reduced vision due to lack of use or stimulation
The treatment options for strabismus may include:
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Glasses or contact lenses. These can correct the refractive error and reduce the eye strain that can cause or worsen strabismus. Some people may need bifocal or progressive lenses to help with near and far vision.
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Eye patching or eye drops. These can be used to treat amblyopia by forcing the weaker eye to work harder and improve its vision. The stronger eye is covered with a patch or blurred with eye drops for a certain period of time each day.
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Using special devices, such as pencils, balls, or computer programs, to train the eyes to focus and move together, eye exercises or vision therapy can improve eye muscle control.
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Injections of botulinum toxin (Botox) or oral drugs, such as baclofen or gabapentin, are used to relax or stimulate the eye muscles and improve eye alignment.
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Depending on the type of strabismus, surgery can be performed on one or both eyes, to change the position or length of the eye muscles as well as the direction of the eye movements. In order to achieve the best results, surgery can be combined with other treatments, such as glasses or eye exercises.
Prevention of Strabismus
The following steps can help reduce or prevent the risk of strabismus in some cases, especially if strabismus is caused by genetic or developmental factors:
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Having regular eye exams, especially for children, to detect and correct any vision problems or eye disorders
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Wearing glasses or contact lenses as prescribed to correct the refractive error and avoid eye strain
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Protecting the eyes from injury or infection by wearing protective eyewear or avoiding contact with contaminated objects
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Managing any medical conditions that can affect the eyes or the nervous system, such as diabetes or thyroid disorders
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Seeking prompt medical attention for any signs or symptoms of strabismus, such as eye misalignment, double vision, or reduced vision
All ages can be affected by strabismus, a common eye condition that can cause a variety of vision problems, as well as affect their appearance and self-esteem. Fortunately, with proper diagnosis and treatment, strabismus can be corrected or improved, restoring vision and quality of life.
