Strabismus

In Strabismus one or both of the eyes turn in, out, up, or down. It usually occurs in children but may occur in adults. Permanent vision loss may result if Strabismus is not detected and treated in a timely manner. There are two types: Constant Strabismus - the eye turns all the time Intermittent Strabismus - the eye turns only some of the time, like in times of stress or illness

Strabismus is caused by a lack of coordination between the muscles in the eyes. This can happen due to:

• Problems, imbalances, or injuries of the muscles that move the eyes
• Nervous system disorders that affect vision, such as:
  • Problems or injury of the nerves that control the eye muscles
  • Tumor in the eye or brain
  • Strokes or bleeding in the brain
  • Increased pressure in the brain
  • Myasthenia gravis
• Hormone problems, such as:
  • Diabetes
  • Thyroid disease
• Vision loss in one eye (one blind eye will often turn in or out)

A risk factor is something that increases your chances of getting a disease or condition.

• Family member with strabismus

Symptoms may include:

• Double vision
• Crossed eyes
• Eyes that do not align properly
• Uncoordinated eye movements
• Squinting

The doctor will ask about your symptoms and medical history, and perform a physical exam. You may receive an eye exam, which may include a visual acuity test and a retinal exam. You may be given a neurologic exam and other tests to rule out other possible causes.

Treatment may include:
Glasses
Glasses or contact lenses may be prescribed to improve your ability to focus and help overcome poor vision. With better eyesight, strabismus may improve.
Patching
A patch is applied over the good eye. This will force the affected eye to fixate properly. The length of time the patch is worn depends on the severity of the condition and the age of the child.

Medication
Eye drops or ointment may be put in the good eye to temporarily narrow the pupil and blur vision. This forces the affected eye to fixate properly and may be used as a substitute for patching.
Injections of botulinum toxin may also be used to treat strabismus.
Surgery
Surgery may be used to straighten the eye muscle if non-surgical means are not successful. There are generally two techniques used. Both may improve the ability of the affected eye muscle to bring the eyeball into proper alignment. These methods involve the eye muscle that is responsible for causing strabismus. The doctor may do one of the following:

• Reattach the muscle at a different site on the eyeball
• Shorten the muscle by cutting a portion of it

There is no known way to prevent strabismus.