Information From Your Health Care Provider

STRABISMUS

BAsic information

description

The eyes are not aligned together, and eyes point in different directions. One or both eyes may turn inward (crossed eyes), outward ("walleye"), upward, or downward. The ability of the eyes to focus is not fully mature at birth. A true eye problem shows up from 3 or 4 months of age. It also may occur in childhood or later. Strabismus may be constant (occurs all the time) or intermittent (occurs some of the time).

frequent signs and symptoms

• Eye movement that is not coordinated.
• Child may look at you with one eye closed, squint, or with the head turned to one side.
• Adults may have double vision, eyestrain, headaches, and/or abnormal head position (from trying to see properly).

causes

Eye movement is controlled by brain signals to six muscles around each eye. Loss of coordinated movement may result from:

• Muscle imbalance between the eyes.
• Lack of equal focusing ability in the eyes. The brain gets a different picture from each eye, so it blocks the one from the weaker eye. The weaker eye becomes more useless from disuse, and a "lazy", or wandering, eye results.
• Brain damage or head injury (rare).

risk increases with

• Family history of strabismus.
• Down syndrome
• Cerebral palsy.
• Eye tumor.
• Damage to fetal central nervous system.
• Birth trauma (injury).
• In adults: thyroid disease, stroke, myasthenia gravis, diabetes, brain tumor, other neurological disease.

preventive measures

No specific preventive measures.

expected outcomes

• With early diagnosis and treatment, strabismus can be corrected. It can take many months or even years. Without prompt treatment, vision loss in one eye may become permanent.
• Many persons adapt well to single-eye vision and learn to drive a car, as well as engage in other activities. If vision is lost in one eye, take extra care against injury in the other eye. Wear goggles for sports and other activities, such as carpentry or welding, which carry the risk of injury.

POSsible complications

Loss of normal vision in one eye.

diagnosis & treatment

general measures

• Your health care provider will do an examination of the eyes. Medical tests may include a visual acuity test, a retinal exam, and others.
• Treatment has three goals—to obtain the best possible vision, gain the best eye alignment, and provide the best chance for binocular (both eyes) vision.
• Glasses or an eye patch may be used over the stronger eye to correct focusing imbalance. These force the weak eye to work. This treatment may be done for only a few hours a day or all waking hours (full-time).
• Eye-muscle exercises (called orthoptics) will improve the eye muscles to help straighten the eyes.
• Vision therapy involves exercises that help the eye and brain learn to work together better.
• Surgery to correct the condition of the eye muscles may be recommended. Sometimes a second operation is required. Your eye care provider will explain the risks and benefits of the surgery.
• A therapy for adults involves the use of eyeglasses overlaid with thin plastic prisms. These are used by a patient prior to surgery. They help determine the amount of adjustment needed on the eye muscles.
• To learn more: American Academy of Ophthalmology, PO Box 7424, San Francisco, CA 94120; website: www.aao.org/aao/public.

medications

Botulinum toxin injections may sometimes be recommended for adults. They are injected into an eye-turning muscle, outside the eye, by using a special needle.

activity

No limits. Protect your child against falls or injury while he or she adjusts to an eye patch.

diet

No special diet.

notify our office if

• You or a family member has symptoms of strabismus.
• Signs of infection develop after eye surgery (redness, pain, fever).

Special Notes:

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