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Eye Turns in Children: "Strabismus"

Strabismus is a vision condition in which a person can not align both eyes simultaneously under normal conditions. It is estimated that up to 5 percent of all children have some type or degree of strabismus. While they may initially have double vision, the brain may eventually disregard the image of one eye (called suppression). Strabismus can be treated with Vision Therapy, and if severe enough surgery may be necessary.

How to Understand Your Diagnosis

Some eye turns only affect one eye, and 'Left' or 'Right' will be included in the diagnosis instead of 'Alternating'. 'Alternating' means your brain is sometimes using the information from one eye, sometimes the other. Some eye turns are 'Constant', which means the eyes never work together to see. Constant eye turns have a worse prognosis and higher chance of lazy eye than 'Intermittent' eye turns. For intermittent eye turns, surgery and/or vision therapy are often very effective solutions.

If the eyes appear to be crossing when they shouldn't, this is called an 'Esotropia'. When the eyes go out it is called an 'Exotropia'. If one eye goes up and one eye goes down, it is a 'hypertropia'. Exotropia is easiest to treat. Hypertropia is the most difficult to treat.

Prognosis by Age

Children under 16 will have more success with treatment of an eye turn. If the eye turn has associated amblyopia ('lazy eye'), it is important to protect the good eye from trauma or risk serious visual impairment. When deciding whether to treat your son or daughters strabismus, it is important to think about how they are affected by the strabismus: both in their ability to perform in school and the cosmetic effect of strabismus on your child's self-esteem. Most children will not openly discuss it, but being picked on at school is a reality for most children with a moderate to severe strabismus.

Surgery vs. Vision Therapy

Surgery can be performed to realign your eyes muscles, but success varies on a number of factors. Patients with a constant and/or hypertropic strabismus are less likely to benefit from treatment of any kind. Vision Therapy pertains to eye exercises to help make your eye muscles stronger and make the strabismus occur less frequently and cause less tiring of the eyes. VT is recommended as a pre and post care for most surgical candidates and can sometimes solve a strabismus without surgery in mild to moderate cases.

Lysle Shaw-McMinn, O.D.

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Written for Our Blog on Oct 30, 2014


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