Crossed eyes, squint (Strabismus) is a condition where both eyes are not parallel and do not work together when looking at the same object. The patient will use only the normal eye to focus on the object, while the squinting eye may turn inward, outward, upward, or downward, causing that eye to be unused.
Meanwhile, pseudostrabismus is often found in children whose nasal bridge is not fully developed and have a wide epicanthus, making it appear similar to inward squint. However, as the child grows and the nasal bridge becomes higher, this squint condition will disappear.
How does strabismus occur?
- It can be caused by many factors, most of which are unknown, but it is believed to be an imbalance between the two eyes.
- It results from abnormal brain signals to the eye muscles, causing the eye muscles to work unevenly.
- It is caused by abnormal development of the eye muscles.
- It is a result of paralysis or dysfunction of the nerves supplying the eye muscles, leading to strabismus.
- Abnormal vision is a common cause in children, which may be due to an eye condition such as retinoblastoma, causing poor vision in that eye and resulting in less use of the affected eye, leading to strabismus.
- Strabismus caused by excessive focusing. Generally, children focus better than adults, but some children focus more than normal, including those who use their eyes excessively, which can cause strabismus.
Impacts caused by strabismus
It not only causes loss of confidence but also affects personality. In children, when they reach school age, they may be teased by friends, causing them to refuse to go to school, suffer from mental health issues, become withdrawn, lose confidence, and it can affect social interaction and learning.
In adults, eye abnormalities are more noticeable than other features. Some people with strabismus try to cover the affected eye with their hair, living as if hiding something, losing confidence, avoiding social interaction, feeling inferior, which affects personality. It also causes loss of opportunities in careers and many aspects of life. Especially if strabismus is accompanied by vision problems, it can make normal life almost impossible. Therefore, surgery to correct strabismus is the best solution.
Is treatment necessary for strabismus in children?
The goal of treating strabismus in children is to eliminate lazy eye because lazy eye can lead to blindness. In a developing child’s eye, if strabismus occurs, it results in less use of that eye, causing lazy eye, which means the eye is underdeveloped. If left untreated for a long time, it may cause blindness in that eye. Therefore, children with strabismus should receive early treatment as it not only affects personality but also may cause loss of vision and affect quality of life in the future.
How to know if your child has strabismus
It can be observed from the age of 5 months onwards. If your child looks at the mother’s face with strange eyes or squints, suspect strabismus and take the child to see a doctor because at this age it is possible to check whether strabismus is present.
Non-surgical treatment
- Wearing glasses to treat patients with refractive errors, such as farsightedness causing inward strabismus or nearsightedness contributing to occasional outward strabismus.
- Wearing prism glasses, which help refract light to fall correctly on the retina.
- Eye muscle exercises.
- Medication treatment such as Botulinum Toxin injection into the eye muscles, which weakens the muscle for about 2-3 months.
What to do if your child has strabismus with amblyopia?
Children with strabismus and amblyopia need immediate treatment before strabismus surgery. Treatment should be done before the child is older than 7 years because after 8-9 years old, treatment is usually less effective and the affected eye may remain permanently blurred.
Treatment for amblyopia involves patching the good eye to stimulate the lazy eye to work. The patch should be worn for at least 2-6 hours a day until both eyes have normal vision. The duration varies for each case.
Surgical treatment for strabismus correction
Strabismus surgery is a minor surgery called Muscle correction, which involves adjusting the eye muscles and realigning them to normal. There are various techniques, and the doctor will choose the appropriate one based on the type of strabismus. The surgery is uncomplicated and performed outside the eyeball. Adults can have the surgery under local anesthesia, while children can have it from 2 years old, sometimes requiring general anesthesia. The results are good for both children and adults.
Postoperative side effects
Vision will return to normal immediately, with possible slight redness of the eye. Eye recovery takes about one week, after which the patient can return to a better quality of life, feeling like a new person.
Self-care after surgery
The doctor will cover the operated eye for 1 day, then normal vision use can resume. For young children, an eye shield is used during sleep to prevent rubbing. During the first week, avoid getting water in the eye to prevent inflammation or infection. The surgery leaves almost no scars or marks. Follow-up visits are necessary to monitor any changes.
Benefits after strabismus surgery
- Eyes appear straight and normal, improving appearance and personality.
- Treatment improves vision efficiency in both eyes, allowing better 3D vision as normal.
Many people believe that strabismus in children can resolve on its own as they grow, but in reality, it does not. Without proper treatment at the right time, permanent vision loss may occur. Strabismus also causes amblyopia. Therefore, it is important to observe your child’s vision behavior or have their eyes checked by an ophthalmologist before school age to prevent these problems from worsening. Early detection allows for much better treatment outcomes.