Strabismus is a condition where the eyes are misaligned and point in different directions, preventing them from focusing on the same target simultaneously.
One eye looks straight ahead while the other eye deviates inward, outward, upward, or downward, causing the gaze to misalign.
Strabismus affects approximately 2 to 4% of children. If it is not detected and treated early in childhood, it can have a permanent impact on visual development.
It can also develop in adults due to trauma, brain nerve disorders, or thyroid eye disease, causing significant discomfort in daily life along with double vision.
Types of Strabismus
One eye is turned inward (toward the nose).
It is the most common type of pediatric strabismus,
including infantile esotropia and accommodative esotropia.
One eye is turned outward (toward the ear).
Intermittent exotropia is the most common type,
characterized by the eyes drifting outward when tired or in a daze.
One eye is turned upward.
One eye is turned downward.
Causes of Strabismus
Eye muscle and nerve disorders
Abnormalities in the six extraocular muscles that move the eyes or in the cranial nerves that control them can cause misalignment of the eyes.
Strabismus occurs when there is a congenital abnormality in the attachment point or length of the muscles, or when specific muscles weaken due to nerve paralysis.
Refractive error
Severe hyperopia causes the eye to overuse its focusing power to see objects clearly, and in this process, the eyes turn inward,
resulting in accommodative esotropia.
Bilateral visual field defect
If the brain's fusion function—which combines the images from both eyes into one—is weak, the alignment of the eyes cannot be maintained,
which can lead to strabismus.
Brain and Nervous System Disorders
Central nervous system disorders such as brain tumors, strokes, cerebral palsy, hydrocephalus, and traumatic brain injury can affect the eye movement nerves and cause strabismus.
Trauma
Strabismus occurs when the extraocular muscles are damaged due to trauma around the eye or when muscles become trapped due to an orbital fracture.
Genetic factors
If there is a family history of strabismus,
If there is a family history of strabismus,
Strabismus Treatment
Eyeglass correction
Refractive errors such as hyperopia, myopia, and astigmatism
are corrected with glasses or contact lenses.
Strabismus surgery
It is performed for strabismus that cannot be corrected
with glasses or non-surgical treatment.
Amblyopia Treatment
When amblyopia accompanies strabismus,
amblyopia treatment must be administered concurrently.
Most cases of strabismus do not improve on their own.
In fact, if left untreated, amblyopia may develop, or binocular vision function may fail to develop properly, leading to permanent vision problems.
In pediatric strabismus, if one eye remains constantly misaligned, the brain suppresses the image from that eye, leading to amblyopia—a condition where visual acuity in that eye fails to develop properly.
Amblyopia requires early treatment for vision recovery to be possible, and treatment is most effective when initiated before age 8 to 10. It is crucial to treat both the amblyopia and the strabismus simultaneously.
Accommodative esotropia often resolves with proper alignment of the eyes using corrective glasses alone.
However, not all strabismus can be corrected with glasses. Strabismus that cannot be corrected with glasses requires surgery.
Accurate diagnosis is essential to determine the appropriate treatment method.
There is a possibility of intermittent exotropia.
If one eye turns outward when you are tired, spacing out, in pain, or looking into the distance, you may suspect intermittent exotropia.
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