Strabismus is an abnormality of the eye position, as a result of which the eyes are no longer focused on the same point. This squinting often occurs in childhood, but the abnormality can also occur in the elderly. On average, 3 to 5% of the population has this eye defect. To prevent a lazy eye from developing, strabismus should be identified at an early age. Lazy eye can only be successfully treated in young children.
Cause of strabismus
We see with both eyes and our brain arranges to create one image from the two different images. This ability develops in the first seven years of life. Factors that influence the development of strabismus: difference in strength of the eyes, an ophthalmological abnormality, the condition of the child around the time of delivery and hereditary predisposition. If strabismus develops after the first seven years, it is often due to paralysis of one or more eye muscles. Since the brain functions are already fully developed at that stage, the fact that someone will see cross-eyed will no longer result in a lazy eye. But unfortunately the person will see double.
Lazy eye is the most common eye condition in children. A young child with a cross-eyed eye perceives everything twice. To prevent double vision, the child unknowingly switches off the abnormal eye. However, if this always happens to the same eye, this eye will develop incorrectly and vision will deteriorate. Then there is a lazy eye. Lazy eye can be corrected if treatment is started before the age of 6. A lazy eye does not go away on its own.
Nowadays, the eyes of small children are examined by nurseries and clinics. If in doubt, the examining person will refer the child to an orthoptist or ophthalmologist. An orthoptist is an expert in the field of squinting in children and its treatment. Although the orthoptist largely works independently, he is accountable to an ophthalmologist.
Treatment can be a long-term issue. Usually the lazy eye will be repaired first and much later the orthoptist will determine whether eye muscle surgery is required. A lazy eye can be repaired in several ways: By masking off the healthy eye, the child practices with the lazy eye and makes progress. Glasses can sometimes also provide a solution, because they give the lazy eye the sharpest possible image. And then there is drop therapy.
Eye muscle surgery
In a number of children, the eyes need to be straightened through surgery. Certain eye muscles are then strengthened or weakened by shortening or displacement. It depends on whether this should be done in one or both eyes. Such an eye muscle correction takes place under general anesthesia. It is usually a day treatment and the parents can be present when you fall asleep and wake up.
After the operation
Nausea may occur initially. And the eyes are often painful, swollen and red. Drops are usually prescribed for this purpose. After about a week, the child will visit the orthoptist again for a check-up. Usually one operation is sufficient, but sometimes a second operation is necessary.
At an older age
Since the patient’s brain has often corrected the double vision, there is a risk that the patient will still see double after straightening the eyes, while he did not (anymore) do so during the strabismus. The chance of such a surprise can be estimated in advance.