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Strabismus – Types, Causes, Symptoms, Diagnosis, and Treatment

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Strabismus – Types, Causes, Symptoms, Diagnosis, and Treatment

What is Strabismus?

Strabismus, commonly known as crossed eyes, refers to the misalignment of the eyes. In this medical condition, the eyes do not align with each other and thus fail to work together as a team.

For patients who have strabismus, their one eye looks directly at the object they are viewing and the other eye is misaligned. This condition may be permanently present or occur occasionally.

If strabismus occurs during childhood, it can lead to a loss of depth perception (steriopsis) and amblyopia (lazy eye) where vision doesn’t improve with glasses. If the onset of strabismus is during adulthood, it is likely to lead to the problem of double vision in the long run!

What are the Types of Strabismus?

Strabismus is classified based on the direction of the eye misalignment. Below mentioned are some common types of strabismus:

  1. Exotropia – Also referred to as wall-eyed, in this type of horizontal strabismus, the misaligned eye turns outwards i.e. away from the nose. It is also referred to as horizontal divergent strabismus.
  2. Esotropia – This type of strabismus is called horizontal convergent strabismus as the misaligned eye turns inwards i.e. towards the nose.
  3. Hypotropia – This is a type of a vertical strabismus. In hypotropia, one eye turns vertically downward while the other continues to see the object.
  4. Hypertropia – Also a type of vertical strabismus, in this condition, the misaligned eye moves vertically upward.
  5. Paralytic Strabismus – Any damage to the third, fourth, or sixth cranial nerves due to a head injury or loss of blood supply can lead to limited eye movement and result in strabismus. This type of strabismus is known as paralytic strabismus.

What Causes Strabismus?

Strabismus can be caused due to eye injury or general health complications.

There are six different muscles in an eye. These muscles, known as the extraocular muscles, control the position and movement of the eye. For a normal human being, the muscles of both the eyes are coordinated but this is not the case with a person who has strabismus.

Owing to an anatomical disorder or a neurological medical condition, the extraocular muscles may fail to function properly and lead to strabismus. The medical conditions causing strabismus may either originate in the nerves or the muscles. At times, the medical issues in the vision centres of the brain can also cause crossed eyes.

New strabismus in adults occurs commonly due to stroke, tumour, eye disease, and even thyroid. In a few cases, the growing age leads to changes in the soft tissues surrounding the eye which can result in strabismus in the elderly.

What are the Risk Factors of Strabismus?

Following are the most common risk factors or strabismus :

  1. Family History: Inheritance is the biggest risk factor of strabismus. If a member of your family has strabismus, you are also at a high risk of developing it.
  2. Medical Conditions: Significant risk factors of strabismus include low birth weight, premature birth, smoking during pregnancy, hyperopia, and anisometropia. Also, people with cerebral palsy and Down syndrome are highly likely to develop strabismus.
  3. Refractive Error: People with uncorrected farsightedness or hyperopia are highly probable of developing strabismus in the long run.
  4. Others – In rare scenarios, strabismus is developed due to another serious abnormalities inside the eye such as tumour or cataract.

What are the Symptoms of Strabismus?

The most common sign of strabismus is the visible misalignment of eyes. Both eyes move differently and do not point in the same direction. Other prevalent symptoms of strabismus are:

  1. Double vision
  2. Poor perception of depth
  3. Squinting with one eye
  4. Excessive eye strain
  5. Headache
  6. Tilting head to one side
  7. Unsymmetrical points of reflection in both eyes

How is Strabismus Diagnosed?

The ophthalmologist will perform a thorough eye examination to diagnose strabismus. Following are the steps of diagnosis:

  1. Patient History – Your doctor will ask a few questions from you to learn more about your symptoms, medical history of other health conditions, medical details of the family members, and other environmental factors that could contribute to your symptoms.
  2. Eye Health Examination – A detailed eye examination will be conducted to analyse the internal and external structure of your eyes and check for eye diseases that may be contributing to the development of strabismus. These testing procedures help the doctors to examine how your eyes respond under normal circumstances.
  3. Visual Activity – The doctor will also measure your visual activity to determine the actual damage to your vision. You might be asked to read alphabets and numbers written on a distant board. Vision is reported in the form of a fraction and the value for normal vision is 20/20
  4. Refraction – The ophthalmologist will conduct refraction to find out the power of the lens needed to correct farsightedness, near-sightedness, or astigmatism.
  5. Alignment and Focus Test – In this examination, the doctor will assess your eyes to see how well they work as a team. After this, the doctor will be able to figure out the problem that prevents your eyes from focussing on an object.

What are the treatment options for Strabismus?

If, after the above diagnostic steps, you are confirmed to have developed strabismus, the doctor will discuss the below-mentioned treatment options with you

  1. Eyeglasses or Contact Lenses – In a few cases, you will need only a pair of eyeglasses or contact lenses to treat strabismus.
  2. Prism Lenses – Prism lenses are the ones where one lens is thicker than the other. A prism alters the path of the light entering it and is thus useful in reducing the turning of the eye to view an object.
  3. Vision Therapy – A series of visual activities can help improve eye coordination and eye focus. These exercises help reduce problems in eye movement and improve eye-brain connect for the eyes to team up.
  4. Eye Muscle Surgery – An eye surgery can help repair the length and/or position of the eye muscle and thus treatment patients with strabismus. In most cases, vision therapy is recommended after eye muscle surgery and this works wonders to improve eye coordination.

Who is the best doctor to get treatment for Strabismus?

Your search for the best ophthalmologist in Hyderabad for the treatment of strabismus ends with Dr. Venugopal Rao Appani at Abhinav Eye Care and Laser Centre, a well-equipped eye care facility for children and adults.

Dr. Venugopal Rao Appani is well qualified and has decades of experience. He has complete thousands of procedures for the treatment of cataract, glaucoma, and other disorders of the eye.

He is renowned for the treatment of strabismus. His patients speak highly of his professionalism and excellence. Get the best care and cure for your eyes from the distinguished Dr. Venugopal Rao Appani at Abhinav Eye Care and Laser Centre. Schedule your consultation today!

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