Strabismus is a condition that causes a misalignment of the eyes, in which the eyes are unable to look in the same direction at the same time. Strabismus is often colloquially referred to as being “cross-eyed” or having a “lazy eye,” but it can appear myriad manifestations. The misalignment can point in any direction and can affect either one or both eyes.
In medical terms, Strabismus is usually named and described according to the direction of the misalignment–either esotropia (inward), exotropia (outward), hypertropia (upward), or hypotropia (downward).
In addition to the cosmetic effects of Strabismus, the condition can cause a range of symptoms and significant medical issues down the line, including vision problems and loss of eyesight. The brain receives two different images, often leading it to disregard the misaligned eye, thus weakening the vision in that eye and compounding the issue. There are additional issues related to depth perception, as the brain no longer sees or properly processes the visual field in 3D. The field of vision blurs, causing significant difficulty in maintaining physical movement and balance.
The cause of Strabismus is generally misunderstood, as it can develop for a variety of reasons. Strabismus often involves a weakened system of eye muscles or nerves that connect to the eye, but it can also develop due to trauma or conditions that involve the portion of the brain that controls eye movement. According to John’s Hopkins, it is estimated that 4% of people in the United States have Strabismus.
Both children and adults can develop Strabismus. Strabismus can form in otherwise healthy children due to traumas or developing brain conditions. It most commonly appears in children with disorders that affect the brain, such as cerebral palsy, Down syndrome, and tumors. Children are at risk for developing amblyopia (deterioration of the nerve pathways between the brain and the eye) in early childhood. Amblyopia is caused by the improper stimulation between brain and eye and is therefore closely related to Strabismus. It’s imperative to stay on top of pediatric eye care and ensure that any necessary corrections are made before a problem progresses.
Strabismus can also develop well into an adult’s life and can be caused in the same way that it develops in children–including stroke, vascular problems, and brain trauma. Issues related to injury or weakening of the nerves and muscles that control the eye contribute greatly to the onset of Strabismus, but it’s important to note that injuries to the nerves or muscles are often the result of brain trauma itself.
According to the American Academy of Ophthalmology, Strabismus in adulthood has a significant negative impact on wellbeing and quality of life for those affected, decreasing their likelihood of being able to: “obtain employment, receive a promotion, or find a partner because of the inability of the strabismic patient to maintain normal eye contact, interfering with communication and interpersonal relationships.” The condition is also closely linked with increased risk of mental illness, including “depression, anxiety, and social avoidance.” Thankfully, these effects have been shown to improve after corrective surgery; therefore, it’s necessary to monitor the condition and consult an ophthalmologist to find the best solution for you.
Strabismus can usually be corrected with non-invasive procedures, but it depends on the cause of the condition in each particular patient and the degree to which the eyes and brain are affected. With early treatment, Strabismus can usually be corrected easily enough in children.
A number of non-invasive procedures exist, including wearing special eyewear such as eyeglasses, bifocals, contact lenses, or eye patches. Orthoptics, which are muscle-strengthening exercises, are often employed alongside this eyewear to strengthen and repair the weakened eye so that the brain learns to use both eyes in conjunction (referred to as binocular vision).
Corrective surgery may be necessary for those facing increased negative side effects of Strabismus. This surgery involves recession and resection procedures, which adjust and reposition the muscles surrounding the eye, depending on whether the issue is due to a weakened or, in certain cases, a strengthened muscle. The goal is to realign the eyes so that the brain can use both simultaneously, which strengthens the connection and diminishes associated symptoms over time.
Keep in mind that you may require more than one corrective surgery or procedure to fully repair the effects of Strabismus. Strabismus surgery is usually a bit of a shock to the brain, as the neural systems connected to your eyes have become accustomed to compensating for the weakened eye and must now readjust to the new position.
Prior to seeking any treatment options, you must consult with a professional and knowledgeable ophthalmologist. Each treatment option has various effects and may not be applicable to the type of Strabismus affecting you or your child.