All about Strabismus

What is strabismus?

Strabismus or “crossed eyes” refers to conditions during which eyes do not line up with each other. Strabismus may happen in adults, but often, its root dates back to “lazy eye” cases in patient’s childhood that were not successfully treated. Strabismus can also occur due to illnesses and injuries. Sometimes infants even born with strabismus. In case of not receiving proper treatment, strabismus can lead to double vision development in patients.

When the eyes are not aligned in the same direction and do not look at the same object at the same time, the eye is said to be strabismus. Deviation of the eye may be inward (isotropic), outward (exotropic), high (hypertropy) or low (hypotropic). Occasionally a combination of these may appear in the individuals. In fact, if the patient’s eyesight is good, the chance of strabismus will be very low. However, if the ocular abnormalities are treated using glasses or surgery, the chance of abnormalities will be reversed. Conversely, if the patient’s eyesight is low and even if there is no ocular deviation, the same problem would be a lack of vision to cause strabismus. Nowadays, ophthalmologists point out that, depending on the type of cause, how is treated, over 95% of the ocular abnormalities are treatable.

What is a binocular vision?

Each eye of ours captures a different picture of the surrounding areas. Healthy people who are not suffering from strabismus or any vision-related diseases have binocular vision. This means that the brain of these people can take two slightly different pictures from two eyes and put them together into a three-dimensional perception of the world around them. People who are suffering from double vision as a result of strabismus cannot make this combination of two pictures, and their brain puts a line up between images.

When strabismus leads to double vision?

If infant borns with strabismus, his or her brain automatically trains itself to ignore the image from one eye. This is done by the brain to avoid double vision. However, for people who are facing this complication in adulthood, the story is different, since the brain cannot simply ignore one eye and the situation can be unbearable. The patient might try different things to get rid of the double vision, such as: covering eyeglass lenses, using prisms or pirate eye patches, or tilting the head. However, none of these solutions can solve the problem completely.

Reasons for the deviation of the eye:

• Muscle imbalances around the eyes
• Brain or head injury
• Hereditary incidence of strabismus
• Eye or brain tumor
• Birth injury
• Stroke
• Diabetes
• High blood pressure (hypertension)
• Thyroid disease
• Down syndrome
• Fetal brain injury
• MS
• Eye Surgery Complications

Symptoms of strabismus

• Eye fatigue
• Headaches when your eyes are open
• Double vision
• Blurred vision
• Reading difficulty
• Sensitivity to light

What kind of surgery is useful for treating the strabismus?

It is quite hard to treat the strabismus, as brain directs and controls the information’s get from eyes. Therefore, cutting and moving the eye muscles cannot automatically change how the brain treats signals. Thus, the success rate of eye muscle surgery in this particular case is not high (something between 30 to 80 percent according to peer-reviewed scientific journals) and strabismus returns after a while. Nevertheless, eye muscle surgery is most successful in cosmetic improvements only. The latter means that following the eye muscle surgery, the patient’s eyes only look aligned while the vision complication remains unsolved. In some cases, doctors may recommend surgery repetition, which needs to be consulted extensively with surgeons, in each particular case.

Strabismus treatment

The strabismus may occur from birthday or may be later. The most common eye disease in children is strabismus which affects 2% of children. If this defect is not corrected in childhood, the child’s eye will become lazy and will lose his or her 3D vision permanently. She may also have social problems at school. To treat this problem, a healthy baby’s eye should be closed at times of the day so that the eye with the problem is not permanently lazy. Approximately 4 percent of the adult population is affected. Adults can also benefit from some eye-tracking treatments that are used for children. Treatment options may include the use of glasses and prisms. Most adults with ocular abnormalities can successfully resolve this problem with surgery. The purpose of eye surgery is to relax or tighten the muscles of the eyeball. These muscles are responsible for moving the eyes. Strabismus in adults can be caused by refractive eye defects, severe hyperopia, trauma, or brain tumors. There are a number of ways to treat eye defects in adults, including:

• Eye drops and ointments
• Normal eye closure to correct laziness
• Ophthalmic exercise
• Prescription of dual focus glasses
• Prescription glasses containing charter
• Extracorporeal muscle surgery

How is the surgery done?

Eye surgery is performed in children with general anesthesia and in some cases with topical of one or both eyes operated. In this surgery, the eyeball does not get out of place and anesthesia. During this operation, the eyelid is opened with special tools and a small incision is made in a thin, translucent membrane over white. Depending on the type of strabismus, the muscles usually it takes 2 minutes to 4 hours for the surgery.

How many surgeries usually the patients need to do?

It is an important question to be addressed by your surgeon. It is quite probable that you, as the patient, might need to repeat this surgery more than twice; therefore, before taking any actions, try to have a clear picture of your treatment procedure.

Does the age of patient matter in treating strabismus?

The answer to these questions depends directly on the type of strabismus and other general condition of the patient. Some cases of strabismus can be successfully treated in the early ages of the patient’s life while the others are not treatable, no matter how old or young patient is. To have a clear picture of how the age factor may or may not affect your treatment procedure, it is better to ask about it from your surgeon.

Why children should have strabismus and eye muscle repair surgeries?

Reconstructive surgery of the eye muscle helps the eyes to become symmetrical and correct and to look in the same direction. This surgery is often performed on children who have this problem, but may only be used for eye muscle problems. There are some doctors who treat this problem with a series of eye exercises or glasses. Eye muscle repair is a solution for those who see no progress without surgery in their eyes.

What are the preparations for eye muscle repair?

A complete eye inspection is executed before eye muscle repair. An ophthalmologist will try to use any pre-treatment to resolve your eye problem. The eye is measured and it is determined whether the eye muscle has become weaker or stronger.

Necessary things to do before strabismus surgery

Approximately 3 days before strabismus surgery, you should stop medications that increase the risk of bleeding.

Medications like aspirin, ibuprofen, sodium naproxen, warfarin and heparin. Fasting before surgery is often needed to prevent anesthesia repercussions, such as nausea and vomiting. Children usually undergo general anesthesia for eye muscle surgery.

In fact, they go to sleep to not to feel pain.

It is recommended that strabismus surgery be performed as soon as the infant has normal vision and binocular vision as soon as his eyes are straightened. On the other hand, strabismus can also have a negative effect on a child’s self-esteem.

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What are the complications after strabismus and eye muscle repair?

As with any surgery, eye muscle repair also has risks. These risks include infection, bleeding and other rare complications that can lead to loss of vision. However, strabismus surgery is typically a harmless and effective treatment. Strabismus hardly is treated by glasses or treatments which are used in the case of amblyopia. High bleeding and infection are possible complications after strabismus and eye muscle repair surgery. The amount of heavy bleeding can be reduced by doctor’s instructions, with bleeding-reducing medications before surgery. The wound site should be dry and clean, helping to prevent infection after surgery

What happens after strabismus surgery?

strabismus surgery is usually an outpatient surgery, therefore, at the same day you go home. The eyes feel a bit painful and itchy a few days after surgery. But you should not rub your eyes. The eyes should be protected from any contamination or irritants to prevent infection. At this time, your doctor will prescribe an eye drops or ointment. You should visit an ophthalmologist about two weeks after surgery.

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We start our professional activity in medical tourism industry regarding the profound capability of Iran in both healthcare & touristic fields.

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