Strabismus is a visual disorder that occurs when the eyes are not aligned, meaning when one eye looks at a point in space, the other deviates in a different direction. When a person has strabismus, they may experience a decrease in depth perception and three-dimensional vision.
When strabismus is congenital or develops during childhood, it can cause amblyopia, a condition in which there is no proper development of the neurological structures responsible for vision. As a result, when reaching adulthood, even if the condition that caused amblyopia (strabismus, refractive error, etc.) is corrected, vision with the amblyopic eye is insufficient and cannot be corrected with any treatment. Amblyopia is reversible during childhood and occasionally adolescence with appropriate therapeutic measures, which in the case of strabismus usually involve patch treatment and eventually the use of glasses.
The eyes of a patient with strabismus should be examined as soon as possible. The goal is to prevent amblyopia ("lazy eye") and allow for the proper development of binocular vision. No child is too young to be examined, and early care can prevent problems that later cannot be corrected. Treatment is most effective when started early. After age 7, the chances are poorer.
Strabismus tests consist of a general examination, corneal light reflex tests, and cover tests. In the cover tests, each eye is covered to detect which is the strabismic one. If the examined eye is the one with strabismus, it will fixate when the "good eye" is covered. If it is the "good eye," there will be no changes in fixation since it is already fixed. Depending on the direction in which the strabismic eye deviates, the type of tropia or phoria can be evaluated.
The first step in treating strabismus in children is to prescribe glasses if necessary.
Then, amblyopia or lazy eye should be treated. A patch is placed over the good eye, which forces the weaker eye to work harder and achieve better vision.
Your child may not like wearing a patch or glasses. A patch forces the child to initially see through the weaker eye. However, it is very important to use the patch or glasses as instructed.
If the eyes still do not move correctly, eye muscle surgery may be needed. Different muscles in the eye will be strengthened or weakened.