STRABISMUS - "CROSSED EYES / WALL EYES)
WHAT IS STRABISMUS?
Simply put, Strabismus is when one eye points straight ahead; the other eye, elsewhere. The misaligned eye may point in towards the nose (Esotropia) or out towards the ear (Exotropia). In other cases it may point up or down. Whichever direction of misalignment, the main concern is that it’s aimed in the wrong direction. Most of the time, Strabismus develops in young, otherwise healthy children.
WHY DO YOU GET STRABISMUS?
Six muscles surround the eye and control where it aims. Normally all these muscles match with the 6 of the other eye, but in Strabismus they do not. A common misconception about Strabismus is that it develops from a weak muscle. This is not always the case. In fact, the 6 muscles outside of each eye are much stronger than necessary; sometimes 100 times stronger than they need to be! The deviation between the two eyes is often actually caused by a miscommunication between the brain and the eyes.
WHY IS STRABISMUS A PROBLEM?
Two major issues arise from Strabismus. One concern is cosmetic. Although babies don’t care about this, the school aged child may be picked on because of their eyes. As they grow older, the teasing stops but the person may remain troubled about what their eyes are doing and how they look.
The other problem from Strabismus is a functional one. People with normal vision match the input from both eyes to create one image. In Strabismus, if one eye drifts away from the other, double images can result. Because double vision is unbearable, the child will shut off or “suppress” the information from the misaligned eye. If this suppression occurs for too long, one of the eyes can become considerably impaired and develops Amblyopia; much like a broken arm which remains in a cast for too long becomes severely weakened.
No Treatment: What happens if nothing is done to counteract these problems? Without treatment the problem will remain the same, or even become more deeply ingrained. The child doesn't usually grow out of the problem.
Surgery: The aim in surgery is to straighten the eyes by shortening or lengthening the muscles that attach to the eyes. If the surgery is successful, you will have straight looking eyes, but sometimes the eyes drift again especially if you learn how to use the eyes together. If this occurs, second, third and other subsequent surgeries may be recommended along with vision therapy to train you how to keep them aligned.
Vision Therapy: It is important to remember that because Strabismus is not always a muscle problem, vision therapy is not designed to make the muscles stronger. Vision therapy is a set of procedures designed to help the patient learn to straighten the eyes. First, each eye receives the training so that the skills are made equal with the other eye. Then, suppression is eliminated and finally the person learns to combine the information from both eyes equally and keep their eyes straightened. This helps the patient’s eye-hand coordination, depth perception and reading often becomes faster. The clumsiness usually experienced when the eyes are not aligned also reduces.
Do you need a Pediatric Ophthalmologist or Strabismus Surgery in Bellingham, Whatcom or Skagit County?
For our patients who need eye muscle surgery, we will most often refer them to eye clinics in the Seattle area for their consultations.