Children’s eyes
Dr. Mustafa Azab is a consultant ophthalmologist and his specialty is pediatric ophthalmology and surgery and treatment around children and
Squint is a common disease that affects about 1% of the general population, depending on its types and forms. Most types of strabismus appear at a young age in childhood, but sometimes strabismus appears in newborns. Strabismus may have a significant impact on children’s vision, and it may also be a warning of serious diseases that cause strabismus. Therefore, strabismus should not be tolerated if the patient is young or old
If you are looking for answers to questions such as: What are the causes of strabismus? What are the symptoms of strabismus? How can strabismus be treated? And other questions related to strabismus, you will find the answers you need in this article
Squint is an unhealthy condition in which one eye deviates from the other, so the visual target for each becomes different. Contrary to a healthy situation in which the visual target for both eyes is supposed to be the same, and thus both eyes turn to the same target and receive the same Image. In the case of strabismus, each eye turns to a different visual target and eye movement is distracted. The picture is of a child looking at the camera light with his left eye while his right eye is directed to a visual target other than the camera light
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Causes of strabismus in adults
In which one or both eyes deviate towards the other, as the following picture shows. There are several types of esotropia, such as congenital esotropia, adaptive esotropia, intermittent esotropia, and other types of esotropia.
In which one or both eyes deviate away from the other, as we see in the picture. There are several types of exotropia, such as intermittent exotropia, constant exotropia, sensory exotropia, and other types of exotropia.
In which the balance of the eyes is disturbed, so one or both of them move to a higher level than the other. If you look at the picture, you will find that the right eye turns upward when looking to the left, and vice versa. You do not find the eyes on one horizontal level. The imbalance of the eyes and one being higher than the other is what is known as vertical strabismus.
Squint may be “fixed”, meaning an apparent length. Time or “intermittent” such as intermittent exotropia, meaning it appears at some times and disappears at other times. Some types of strabismus appear from birth, such as congenital esotropia, and others during childhood, such as intermittent exotropia. There are some types that appear after puberty or at older ages. Some types of strabismus appear gradually, and some appear suddenly. We always note that the types of strabismus that appear suddenly may be a warning of serious diseases causing.Strabismus that occurs during childhood, if parents do not care about treating it, affects the visual functions of the eyes, reducing the field of vision, preventing the brain from forming three-dimensional images, and may lead to functional amblyopia in one eye.
Squint has many causes, and most of the time the underlying cause cannot be found. Strabismus may be congenital (i.e., appears shortly after birth), such as cases of muscle fibrosis and congenital esotropia, or it may be acquired (i.e., not related to birth), such as cases of muscle paralysis. Strabismus may be hereditary, so we find in some families a specific type of strabismus that was present in the first generation of grandparents, as it appeared in the parents’ generation and then the grandchildren’s generation.
Most types of strabismus do not have a clear and apparent pathological cause, but there are types of strabismus that result from poor vision in one or both eyes, and there are types of strabismus that may result from the presence of other eye diseases such as retinal diseases and cataracts, especially in children. There are also some types of strabismus that may result from serious diseases such as brain tumors and other neurological diseases such as multiple sclerosis and muscle weakness.
Therefore, the patient must go to consult a doctor as soon as he notices strabismus, regardless of age. The doctor must rule out any dangerous causes before treating strabismus.
The strabismus treatment plan goes through several stages:
First: Excluding the causes of strabismus that may affect the patient’s general safety
Second: Excluding the causes of strabismus that may affect the health of the eye and the ability to see
Third: Correcting vision defects and treating lazy eye, if any
Fourth: Treating strabismus using one or some of the following methods
Some types of strabismus can be completely treated with medical glasses, such as fully accommodative esotropia, where eye movement is completely regulated once you wear the glasses and you do not need more than that. There are other types of strabismus. Glasses are part of the treatment, not all of the treatment. The patient may need other procedures, such as surgical operations, in addition to medical glasses, such as cases of intermittent exotropia accompanied by farsightedness, myopia, or astigmatism.
Some types of strabismus, especially those accompanied by double vision, can be treated by adding prismatic lenses to medical glasses, such as cases of strabismus resulting from paralysis of the eye muscles.
There are several types of exercises that can be used to treat strabismus, such as covering one eye. If the strabismus is caused by poor vision in one eye in a young child, leading to lazy eye, then the other eye is covered to stimulate The weak eye, the alternate lid, or other exercises depending on the condition and its requirements
There are two types of materials that can be used to treat strabismus. The first is Botox, which is known for its use in cosmetic surgeries. Botox can be used to treat some types of strabismus. It is injected if one of the eye muscles works excessively, causing strabismus. Botox weakens the injected muscle, which restores the balance of the eye. The other type is bupivacaine, which is injected into the weak muscle to strengthen it, unlike Botox.
The strabismus correction process has several types and is not a single operation as some believe. Each operation has its own details, requirements and precautions. Each type of strabismus has appropriate operations, and the strabismus operation is determined according to the type of strabismus. Depending on the patient’s age, the range of vision in each eye, and which muscle causes strabismus.
The goal of the strabismus surgery is to restore the balance of the eyes to the correct position and correct the defect in eye movement, if any. The success of the squint operation has many benefits and many positive effects:
Health benefit: Trying to bring the eyes back together to improve the field of vision and obtain a three-dimensional image
Cosmetic benefit: improving the shape of the eyes and their movement together
Psychological benefit: restoring self-confidence and improving the patient’s psychological conditions
Social benefit: Strabismus correction gives the patient a better chance at professional and social acceptance
In general, strabismus surgeries are very safe and simple surgeries. Its side effects are considered simple, and there are no serious or major problems except in very rare cases. But all treatment methods – whether medical or surgical – for all types of diseases have complications and side effects that may occur. These complications cannot always be predicted. Complications may be the result of a surgical procedure, an eye problem, or a problem in another area of the body. The body’s reaction to the surgical procedure varies from one patient to another, according to the body’s reaction to the medications used in treatment or materials used in surgery, according to the body’s method of healing wounds, and according to the presence of other medical problems in the eye or other organs of the body. Complications of squint surgeries include the following examples: – The need for another surgical intervention to correct strabismus: The final result of the surgery does not appear before a month and a half to two months after the operation. If strabismus remains present after this period, the patient may need one or more other surgical procedures. Each person responds differently to the same digital amount of adjustment of the external muscles of the eye, and the brain’s response also varies in trying to correct the angle of strabismus. – Weak eye movement in one direction – Change in the shape or position of the eyelid – Double vision: It is often temporary if it occurs and rarely. It does not require surgical intervention or the addition of a medical prism to the glasses – Infection: is often simple and is treated using antibiotics and rarely affects the functions of the eye.
Dr. Mustafa Azab is a consultant ophthalmologist and his specialty is pediatric ophthalmology and surgery and treatment around children and
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