Strabismus

Strabismus is a relatively frequent condition of preschool age, although it can manifest at any age. The patient with strabismus cannot focus on the same spot/object with both eyes simultaneously. Their eyes exhibit a deviation. The degree of deviation (strabismic angle) varies from patient to patient, and it sometimes varies within the same patient as well.

There are many types of strabismus, in relation to the cause and their morphological characteristics (convergent, divergent, vertical, rotational, manifest, latent, paralytic, non-paralytic).

Strabismus, in addition to its aesthetic problem, can affect the development of vision, and disrupt many other vision-dependent functions.

In a squinting eye, the progression of vision is interrupted; this is when amblyopia (lazy eye) is observed, and the patient loses the ability of stereoscopic vision, to perceive the depth dimension.

Although the most common causes of strabismus in children are heredity and refractive disorders, brain and other chronic diseases, as well as a serious pathology within the eye, complement the list of causes.

Strabismus that occurs at late age is uncommon, and is usually attributed to pathological causes or trauma, and is accompanied by diplopia.

Treatment of strabismus in children aims at aligning the two eyes and improving their vision-dependent skills, while treatment for strabismus in adults is mainly aimed at relieving diplopia.

Strabismus, depending on the age of the patient, is usually treated with:

• Glasses (simple or prismatic)

• Treatment with eye covering (if amblyopia coexists)

• Botox injections

• Surgery

• A combination of the above

Patients who shall undergo surgery for strabismus should be aware of the following:

• Although strabismus surgery is one of the low-risk surgical procedures with respect to vision, it is likely to be accompanied by a slight possibility of complications. These may occur during, or after surgery is completed, but they are all reversible, through a proper therapeutic approach.
• The objectives of the surgery.
• Depending on the patient’s age, type of strabismus, and their personal experience, the surgeon chooses the appropriate surgical technique.
• 99.5% of procedures are performed on the same day (duration of surgery, as well as recovery at the clinic may vary, depending on the case).
• In all pediatric patients and in most adults, surgery is performed under general anesthesia, unless there are other reasons, so adults have the option of local anesthesia (the decision is made jointly, by the doctor and the patient).
• The fact that the patient shall be on a medication for about a month.
• That their eyes obtain their final position within 1 ½ month after surgery.
• Every case of re-surgery, as well as cases of complex strabismus, are technically more difficult and require the intervention of an experienced surgeon.