What Is Strabismus?
Strabismus or squint is a condition in which the eyes are not aligned properly to focus a fine image on the retina. The eye or both eyes can be deviated upwards, downwards, or sideways. It is due to improper coordination between the extraocular muscles of the eye. Some muscles or one muscle can be fibrosed or tight while others might be looser. If the strabismus occurs at an early age, it can lead to reduced depth perception called stereopsis.
Strabismus is not only cosmetically a disfiguring disease but also associated with reduced vision. Timely recognition of strabismus and early strabismus treatment can lead to a better visual outcome.
Early strabismus treatment strategies include strabismus treatment without surgery such as correction of refractive error, patching, and prescribing prisms. While the surgical procedure includes loosening and tightening of the involved muscles called recession and resection respectively. The following points should be kept in mind for strabismus treatment without surgery and with surgery.
- Age of the patient at the onset of strabismus
- Current age
- Overall health status
- Patient’s developmental level
- Concerns of the patient and/or parents
- Symptoms and signs of visual discomfort
- Visual demands of the patient
- Size and frequency of the strabismus
- Presence or absence of amblyopia
Types Of Strabismus:
Strabismus is broadly divided into esotropia and exotropia.
Esotropia: In esotropia, there is the inward deviation of one or both eyes.
Exotropia: In exotropia, there is the outward deviation of one or both eyes.
Both the condition can occur in the near and far distance as well as in any other direction of gaze. Besides these two types, strabismus can have an accommodative element, in which the accommodation supplied by the ciliary muscles is less as compared to the convergence power needed.
In another case, esotropia may result due to a high level of hypermetropia labeled as fully accommodative esotropia. One other type is intermittent exotropia, in which the eye is in an outward direction during visual inattention.
Causes of Strabismus
Strabismus can be caused due to sensory or motor discoordination. In some cases, there is opacity in the cornea or lens which leads to strabismus. There can be muscular disintegration problems, as happens in Duane syndrome and others. Strabismus can also occur as a result of surgery for strabismus, in that case, there will be over or under correction.
Differences in refractive error between the two eyes may result in depression of one eye and resulting in strabismus. It is called stimulus deprivation amblyopia.
Strabismus Complications:
Problems that can occur if the squint is not treated?
Various types of problems may arise due to strabismus. These are
Not an eye muscle problem
Strabismus can not be directly related to a muscle problem. In fact, there is a problem with coordination between the eye and brain. There are few cases in which there can be a direct muscular problem e.g., Duane syndrome and Mobius syndrome.
The cosmetic problems
It is the major concern when strabismus is detected in the initial stages. It can lead to various psychosocial problems as well, especially when a child with strabismus has to face other children in school and other places. The disfiguring appearance will lead to low self-esteem.
The seeing problem
The human eye is normally trained to perceive images from both eyes combine and makeup one fine image. Any condition affecting the normal pathway from eye to brain will lead to suppression of that particular eye leading to strabismus.
Strabismus Diagnosis:
The initial presentation of strabismus is as followed
- Headache
- Vision problem
- Manifest squint
- Loss of depth perception
To diagnose strabismus, the health care provider will perform the following examinations to reach the final diagnosis
- Visual equity in adults, and retinoscopy in children
- Corneal light reflex test
- Cover/ uncover test
- Complete ophthalmic examination under a slit lamp.
Squint/Strabismus Treatment Without Surgery:
Can squint be corrected without surgery? for treatment details Click Here
