There are six muscles in each eye that have to combine to look in nine directions: three to look up (right, center, left), three straight ahead, and three down. Lack of coordination in this movement gives rise to strabismus.
1. In most cases of strabismus, there is a problem related to the muscles of the eye. For some unknown reason, there are hypertonic or hypotonic muscles, that is, stronger than normal muscles or weaker muscles; The strength of these six muscles is not balanced and therefore some pull more than others, causing the eye to twist towards the stronger side.
2.Strabismus can appear as a result of a vision problem, especially hyperopia. In hyperopia, the child has to make a lot of effort to look closely. When he is tired, both eyes normally turn inward, but he can also twist them when he is not tired, which is why it is called an accommodation effort.
What problems does strabismus cause in children?
- When a child has strabismus, the brain receives two different images and chooses to cancel one of them. Over time this results in a lazy eye (amblyopia). If we don't treat a lazy eye soon, the brain becomes accustomed to looking out of one eye and ignoring the information it receives from the other.
- The result is that the child ends up seeing with only one eye, which can become a lifelong problem, because due to lack of use, the pathways that carry information from the eye to the brain stop working. Furthermore, after a certain age, beyond six or eight years, it is very difficult to recover the vision of that lazy eye.
- The treatment of strabismus is very important. It is never too early to detect or treat it; In fact, the sooner it is diagnosed, the easier your recovery will be. We must not forget that it does not disappear spontaneously.
My son twists his eye: how is it treated?
- First, the ophthalmologist does a vision study to find out if the cause of the strabismus is a refractive disorder (myopia, hyperopia or astigmatism). Normally strabismus is more associated with farsightedness, but sometimes it can be related to myopia, for example, or to a cataract that causes the child to not see well out of one eye, stop using it, become weak and squint from time to time. Sometimes it is strabismus that warns us that the child has a lazy eye.
- If the cause of the strabismus is a vision problem, the first measure is to put glasses on the eye. In that case the doctor will advise operating and will explain the different surgical solutions that are available to us today.
- There are exercises for the eye muscles that serve to improve certain movements, but they do not solve strabismus, so they are used as an aid. So vision problems are ruled out, surgery is almost always the most common solution.
- Eye retraining with patches is done before the operation if possible, since it is important for the brain to recognize the information sent to it by both eyes.
The operation
Today two types of strabismus surgery are performed, the traditional one and the operation with botulinum toxin:
When to operate?
In general, between three and five years old is a good age to do it. At this age it is easier for the child's brain to get used to the new situation: for the two eyes to be coordinated when looking and send two images that can be integrated.
If you wait until the child is older or adolescence, it is possible that he or she will improve aesthetically, but it could happen that the brain does not integrate the new global vision offered by both eyes. Congenital strabismus is also corrected with surgery, and in that case, and given that it appears from the first moment, an early operation is recommended, in the first year of life. Therefore, the sooner we consult, the better.
False strabismus
- There is what is called false strabismus, that is, it seems that the child has a strabismus but he does not have it (their eye muscles work perfectly). This is an optical effect caused by the width of the bridge of your nose.
- On the other hand, some babies may twist their eyes slightly in the first months of life, especially when they are very tired or when breastfeeding. It is relatively common.
- But if after three months you continue to twist one eye, even sporadically, we should inform our doctor and start looking for solutions.
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