What is children’s strabismus?
Strabismus is an eye disease characterised by the loss of parallelism of the eyes, causing one or both of them to deviate from their normal position. This deviation can occur in any direction: inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia). It can also be intermittent or constant.
It is one of the typical childhood eye diseases, affecting about 4-5% of children. It can appear from the first months of life (congenital strabismus) or years later and even in adulthood (link to adult strabismus).
Diagnosing and treating it early is key to prevent the child from developing visual problems as a result of this eye misalignment. The most important of them is amblyopia or “lazy eye” (link), derived from the compensation the brain carries out for not seeing double, thus suppressing the vision of one of the eyes. Another consequence of childhood strabismus is the lack of development of binocular vision and stereopsis, which allows them to see in relief, perceive depth and calculate distances. Last but not least, the aesthetic and psychological effect that having a deviated eye can have on the child.
The main manifestation of childhood strabismus is the eye deviation itself. However, this is not always visible to the naked eye, especially when it is intermittent and only becomes evident in certain circumstances, particularly in a state of fatigue or weakness (a feverish process, sleepiness, at the end of the day, etc.). Seeing an ophthalmologist regularly for a comprehensive eye check-up can help prevent these cases from going unnoticed.
There are different types of childhood strabismus, depending on the causes that generate them. An important group is due to the presence of refractive errors, which are very common in childhood and can cause the eye to deviate in order to focus properly. This is the first cause to be ruled out, but there are also other less frequent pathologies that can cause it, such as eyelid ptosis, retinal detachment or even neurological disorders or tumours.
On other occasions, childhood strabismus has no known cause, although the chances of suffering from it increase, if there is a family history or the child has been premature.
Based on the ophthalmological diagnosis, we can choose different treatment options. If it is accompanied by a refractive error, it is often enough to prescribe glasses with the appropriate prescription. If we are dealing with a lazy eye, we have to encourage its use, either through optical correction, occlusion patches, etc. Vision therapy may also be indicated in some cases. If strabismus persists, despite correcting these associated problems, it may be necessary to act on the extraocular muscles that control eye movement to modify their action. This involves techniques such as botulinum toxin injections to temporarily weaken the action of certain muscles or surgery for childhood strabismus, which is performed by specialists in paediatric ophthalmology at the Miranza clinics.