Strabismus
Strabismus Treatment Brisbane
What is strabismus?
Strabismus is a common condition in which the eyes appear to be misaligned and point in different directions. Also known as lazy or crossed eyes, people with strabismus find that their eye/s turn inward, outward, upward or downward. While strabismus can occur at any age, it is most common in infants and young children, although up to four in every 100 adults also have the condition. In young children, if left untreated this can lead to permanently reduced vision in the affected eye. Strabismus in adults is usually more concerning, as it can lead to visual, physical and psychosocial disabilities.
Strabismus can occur all the time (constant) or part of the time (intermittent). Intermittent strabismus typically worsens when the eye muscles are tired, for example, late in the day or during an illness.
Having proper eye alignment is essential for good depth perception, avoiding seeing double and preventing poor vision development in the affected eye. When the eyes aren’t correctly aligned, the brain receives two different images. While this may only create double vision and confusion at first, the brain will learn to ignore the image from the turned eye over time. If left untreated, this can lead to permanently reduced vision in the affected eye, known as amblyopia or lazy eye.
What causes strabismus?
Six muscles that attach to each eye control how the eyes move. Under normal conditions, these six muscles work together to point both eyes in the same direction. Anything that affects the way these muscles work together can result in strabismus.
Adults with strabismus usually have had the condition since they were a child. However, strabismus can develop in adulthood, usually due to medical concerns, including:
- Eye muscles sagging with age
- Nerve damage to the eye muscles
- Thyroid disease
- Brain tumours
- Head trauma
- Stroke
- Myasthenia gravis
- Following cataract or retinal surgery
Types of Strabismus
Esotropia
Hypertropia
Exotropia
Hypotropia
What are the symptoms of strabismus?
People with strabismus may experience the following symptoms, which may be constant or intermittent:
- Crossed eyes
- Double vision
- Uncoordinated eye movements
- Eye fatigue
- Pulling sensation around the eyes
- Difficulty reading
- Loss or lack of depth perception
- Needing to tilt the head to look at things
- Frequent blinking or squinting, particularly in bright sunlight
How is strabismus diagnosed?
Dr Jayne Camuglia can check for strabismus during a comprehensive eye exam. Anyone who displays signs of strabismus should undergo a complete eye exam, with special emphasis on how the eyes focus and move. Testing for strabismus may include:
- Reviewing patient history
- Measuring visual acuity
- Testing refraction
- Completing alignment and focus tests and examining overall eye health
How is strabismus treated?
Depending on the type of strabismus and the problems it is causing for you, treatment is tailored accordingly and may include one or a combination of exercises, eye patching, glasses, muscle relaxant injection or surgery.
Eye Patch: Wearing an eye patch is a simple way to resolve double vision and improve the strength of the misaligned eye.
Prism Eye Glasses: Prism lenses can help correct the double vision associated with strabismus. When worn, the prisms alter the light entering the eye and realign images together so that the eyes only see the one image.
Eye Muscle Surgery: Surgery is the most common treatment for strabismus. This procedure aims to loosen, tighten or reposition selected eye muscles to rebalance the eyes.
Frequently Asked Questions
Strabismus surgery involves adjusting the eye muscles to improve the alignment of the eyes. In children and adults this procedure is performed under a general anaesthetic.
During the procedure, Dr Jayne Camuglia will make an incision in the conjunctiva to access the muscles. This procedure does not require any bandages, as sutures are absorbable and most dissolve by 8 weeks. Once the incision has been made, Dr Camuglia will either weaken, tighten or move the eye muscles, depending on the cause of your strabismus.
Before undergoing eye muscle surgery, Dr Jayne Camuglia will let you know of any steps you may need to prepare. This could include fasting beforehand, stopping certain medications or taking antibiotic eye drops. You will also need to arrange for someone to drive you to and from the procedure.
Following strabismus surgery, you will experience some redness and swelling at the surgical site. Any pain or discomfort felt can be treated with over-the-counter pain medication such as paracetamol. If needed, Dr Camuglia can prescribe stronger medication. Eye muscle surgery does require a few days of downtime, however, you should be able to return to work or your child to school within a week.
While you may see an improvement in eye alignment within a few days, it may take four to six weeks to notice more permanent results. Young children may require additional procedures to achieve the best possible alignment.
Dr Camuglia usually recommends no swimming or sandpits/beach holidays for two weeks after strabismus surgery and prescribes drops to use at home for 2-4 weeks afterwards.
No procedure is without risk. Although complications after eye muscle surgery are uncommon, they may include:
- Eye infection
- Retinal detachment
- Failure to correct misalignment
- Swelling
- Bleeding
- Change in pupil size
- Loss of vision
If you notice anything abnormal following strabismus surgery, you should get in touch with Dr Jayne Camuglia immediately.
Dr Jayne Camuglia is a General Adult and Paediatric Ophthalmologist with a particular interest in strabismus. If you believe that you or child may have strabismus, please get in touch to see Dr Camuglia today.