Strabismus (Squint) & Amblyopia (lazy eye)

 

What is strabismus?

A Strabismus (turned eye) is the term used to describe the condition where both eyes are not looking in the same direction.  One eye looks at the object of interest, whilst the other eye looks in another direction (most often in towards the nose, or out towards the ear).  Strabismus affects between 2% - 4% of the population and occurs equally in males and females. 

 

A Strabismus can occur at birth, in early childhood (3 - 4 years of age) or after injury or illness.  You may always notice the eye turn, or it may come and go. The eye turn will usually be more noticeable when the child is tired or unwell. 

 

How does strabismus affect vision?

With normal vision, both eyes look at the same object. The brain fuses the two pictures into a single three-dimensional image.  When one eye is turned, two different pictures are sent to the brain. 

 

If strabismus occurs in a young child, prior to the visual system maturing, the brain learns to ignore the image form the turned eye.  As a result, vision in the turned eye is weaker than the straight eye.  This condition is called AMBLYOPIA.  If Amblyopia is not treated early (prior to 8 years of age), then poor vision in the turned eye will persist and remain untreatable.

 

If strabismus occurs in adults, the patient may experience double vision (Diplopia).

 

How is strabismus treated?

• The cause of the turned eye is first established.

• The need for glasses is evaluated and sometimes these are prescribed as they can eliminate or reduce the size of the turn. 

• If amblyopia exists, then occlusion therapy (patching) is prescribed to improve the vision, but this will not correct the turn.

• Sometimes the turn needs to be corrected with surgery.  This involves surgically realigning the eyes so that both eyes are looking in the same direction.  Surgery may also be performed to improve the cosmetic appearance of the turn, in order to avoid teasing by other children and to improve social skills and self-esteem.

 

What will the glasses do?

Some kids have “long sightedness” and they need to do an extra effort to see compared with kids with normal eye sight. When they look at something close to their face, like reading, they had to do even more effort. This extra effort may result in a turn in their eyes. The glasses help them to see clearly and also eliminate –or reduce- the need for the extra effort. This usually helps with the eye turn.

 

How long will he need to wear glasses for?

This varies from one kid to another. He will need to be monitored every few months and the glasses will need to be adjusted as he grows up. Depending on the degree of “long-sightedness” some kids can grow

out of the glasses

 

What is patching for?

Some children have lazy eyes.  Meaning they significantly favour using one eye over the other. As a result the weaker eye gets neglected and does not develop the full visual potential. While the kid is still young, by closing the good eye with a patch, we are forcing him to use the weaker eye to give it a chance to catch up.

 

My child does not like patching?

That is quite normal.  By covering the good eye and forcing him to use the weaker eye he feels disadvantaged and naturally he will not like it. But it is worth the effort as the opportunity to improve the weaker eye diminishes as he gets older. You may try to make it like a game by wearing a pirate patch. Some families kept a diary of the patching days and put a star every day patching was done and agreed on a reward once the kid reaches the target.

 

If he needs surgery, is it safe at his young age?

Modern anaesthetics are relatively very safe. Obviously there is a risk with anything we do . The risk to his life from anaesthetics is extremely low. The risks to his eye from the surgery are very small. Some kids may need more than one surgery to achieve their best results.

 

Do I need to get my other kids examined?

If there is any concern it will be a good idea.