Strabismus Insights
Have you ever met a person with naturally crossed eyes or a “wandering eye”?
Often, crossing our eyes is something we can do voluntarily, maybe for a silly picture or to make a funny face. Other times, although you may try to be polite in conversation, it can be difficult to ignore a vision abnormality face-to-face. A misalignment of the eyes, causing one or both of them to point in an off-center direction, is called strabismus. Strabismus is usually easy to spot, because an eye actually turns in, out, up, or down relative to where the other eye is looking. This is one of the primary eye conditions we treat at Brighter Outlook Vision (BOV).
If you suspect that you or a loved one may have amblyopia or strabismus, it is essential to consult a developmental optometrist to prevent potential lifelong challenges associated with these conditions. A developmental optometrist, such as Dr. Jesse Willingham, conducts comprehensive evaluations that go beyond standard eye exams. This in-depth testing done by our strabismus eye specialist helps identify the root causes and allows the doctor to develop an effective treatment plan tailored to the patient’s needs.
There are various ways to identify the type of strabismus a patient may have. One way is by the direction of the turning eye. A person with strabismus may not always have a misalignment in their horizontal posture. Some patients have a hyper- (upward) or hypo- (downward) turn of the eyes. An inward turn is called esotropia, while an outward turn is exotropia. Another way to categorize strabismus is by the frequency of the eye turning. Are the patient’s eyes always in this position? Does it only appear when they are trying to focus on an object or perform a difficult task? A constant strabismus will stay apparent, while an intermittent one will come and go depending on the job at-hand. One last categorization will be dependent on if one or both of the eyes has strabismus (unilateral or alternating).
The symptoms of strabismus can significantly affect a patient’s day-to-day tasks, schoolwork, and self-confidence. These include:
– Eyes that look misaligned
– Eyes that do not move together
– Frequent blinking or squinting, especially in bright sunlight
– Tilting the head to look at things
– Faulty depth perception
– Difficulty judging distances
– Difficulty catching and throwing objects
– Clumsiness
The eyes need to be able to work together, in coordination with the brain, so they can both fixate (keep their focus) and accommodate (clear an image) properly. Strabismus makes this a difficult task because the positioning of the eyes provides two different images from each eye. These images do not match up perfectly in the patient’s visual field, and they can suffer from blurriness or double vision. Other symptoms include eye strain, fatigue, headaches, poor 3D vision, and low self-esteem due to their cosmetic appearance. Grown ups have a much better grasp of proper social etiquette, we while can be very quick to call out differences in other children. Most of the time, kids do not have the social awareness to be mindful of their comments on another’s physical appearance. Early intervention for strabismus is helpful for relieving the symptoms for patients physically, emotionally, and socially.
Some of the ways to treat strabismus include:
- adding or upgrading a glasses prescription
- vision therapy
- patching an eye or other types of occlusion (especially for strabismic amblyopia) https://brighteroutlookvision.com/patching/
- strabismus surgery*
*Surgery cuts and repositions eye muscles, but doesn’t actively develop binocular vision. The perception of binocular vision occurs in the brain, and is maintained by feedback from the brain aligning the eye muscles. This means strabismus surgery addresses the muscular component of strabismus but not the sensory-perceptual component. This might be why eye muscle surgery is only successful about 60-80% of the time. Vision therapy is an effective, non-surgical way to manage strabismus, or can be a wonderful counterpart to surgery when both are indicated.
Strabismus is often a lifetime condition with different steps in the management process along the way. A glasses prescription and a few eye exercises to practice routinely may be all the intervention needed to make the condition manageable for a patient, especially when beginning at a young age.
Another method we use to treat strabismus is vision therapy (VT). Vision therapy can help by retraining the eyes to coordinate and work together with the neuromuscular system. This is done through activities that work with the eyes monocularly (one eye), bi-ocularly (both eyes, but not together), and binocularly (both eyes together). Over time the patient can learn to control their eye movements, training themselves to fixate and accommodate properly. This can prevent vision loss and boost the patient’s ability to navigate the world, even with strabismus.
Optometric vision therapy is a highly effective, non-invasive treatment for amblyopia and strabismus. This therapy trains the brain to better communicate with the eyes, enhancing the ability to understand and navigate the world. It addresses the core issues by teaching the eyes and brain to work together. While younger children may adapt more quickly, individuals of any age can benefit from treating amblyopia or strabismus. Adult patients may require longer treatment programs than children, but each person’s journey is unique and personalized.
Connect with us to explore how our children’s eye specialist can help your strabismus and can open up a whole new world for you or your loved one!
