Normally both eyes should look straight in parallel with each other but in the case of strabismus eyes are not properly aligned with each other. When one eye is looking in a certain direction the other eye will stray to a different direction. Each eye has 6 muscles which moves the eye in different directions. Weakness occurring in one or more of these muscles will prevent it from performing this task and the result is strabismus. This may be an occasional problem or it may occur constantly. Strabismus may be congenital, present from birth, but can also develop later.
Pseudostrabismus is the false appearance of strabismus. It generally occurs in infants and toddlers where the anatomical structure of the eye, for example, the width and flatness of the bridge of the nose, causes the appearance of strabismus. Especially side glances can wrongly give the impression of strabismus. False strabismus is a condition that should be monitored, but does not require treatment.
Strabismus occurs mostly in childhood. The direction of the eye may stray inwards, outwards, up or down. If both eyes are unable to look in parallel with each other double vision occurs, or as a result of the suppression of one eye, lazy eye (amblyopia) occurs, and so the outcome is permanent visual acuity loss. Treatment of amblyopia caused by strabismus is only possible until the ages of seven or eight. Therefore, it is important that parents should not neglect childhood eye examinations. Children should visit an expert ophthalmologist at the age of one, four and prior to starting school.
Congenital strabismus usually does not require glasses, and should be operated on immediately in the first 6 months or 1 year. Strabismus occuring around the age of 3 can usually be treated with glasses. If the condition does not improve before school age, despite the use of glasses, then surgery is required. Surgical treatment intervenes with the eye muscles to resolve the imbalance between them.
The biggest problem in childhood strabismus is lazy eye which is the result of the straying of a single eye. Vision in the lazy eye is reduced and this cannot be increased with spectacles. In this case, the good eye is patched on a part-time basis, forcing the lazy eye to work and focus. Lazy eye in adults and children older than 10 years cannot be treated using the eye-patching method. In this case Neurovision treatment is applied in order to improve sight.
Strabismus is not only seen in childhood, it is also seen in adults. Conditions such as trauma, strokes, diabetes, hypertension and thyroid can cause strabismus in adults. In this case, the person may experience double vision, eye pain, difficulty reading, headaches, and an abnormal positioning of the head to prevent double vision. Treatment is with the help of special prismatic glasses or surgery.