Strabismus

WHAT IS STRABISMUS? Strabismus is a deviation or misalignment of the eyes where one eye is turned inward, outward, upward or downward. Strabismus is not uncommon and usually begins in childhood, but it may occur at any age.

The cause of strabismus in childhood is not fully understood. We do know that heredity plays a role. However, strabismus may occur when no relatives have the problem. It affects males and females equally. Strabismus may also develop as a result of other problems. A child with conditions such as cerebral palsy, Down's syndrome and hydrocephalus often has strabismus. An eye that is out of focus with the other eye, or an eye that has been injured or has a cataract or tumor may develop strabismus.

The primary symptom of strabismus is an eye that is not straight. Other symptoms include squinting one eye in bright sunlight or having trouble with coordination of body movements and depth perception. Some children turn or lift their heads in order to use their eyes together. Fatigue or illness may worsen strabismus.

Parents may get the perception that the child will outgrow the problem. If it is suspected that a child has strabismus, an immediate examination by an ophthalmologist is necessary to determine the cause and begin treatment.

WHAT IS AMBLYOPIA? Amblyopia, or lazy eye is when one eye develops good vision and the other doesn't. The condition is common, affecting one or two of every fifty people. Amblyopia can be corrected only if treated during infancy or early childhood. Parents should be alert to this threat because it will affect children's vision later in life. Most primary care physicians test a child's vision as part of a routine medical exam and refer the child to an ophthalmologist if they detect any signs of amblyopia or related conditions. Nonetheless, a complete eye exam by a pediatric ophthalmologist should be done for every child between the ages of three and five.

Treating amblyopia requires forcing the weak eye to be used. This is usually done by temporary patching the good eye or by blurring the vision in the good eye with eye drops or glasses. If the eyes are misaligned or an abnormality such as a cataract is discovered, the ophthalmologist may also prescribe medicine or surgery to correct the problem that is causing amblyopia.

An ophthalmologist can instruct parents on the treatment of amblyopia, but it requires much parental involvement to carry out the treatments. Since no child likes to have his or her good eye patched, the parent will have a vital role in determining whether the child's amblyopia will be corrected. Time can be detrimental to an amblyopic eye. If the problem is detected and treated early, most amblyopic eyes will have improved vision. However, if the condition is discovered after nine years of age, it is often too late.