Strabismus: Impact on Both Adults and Children Explored
Data from the Brazilian Institute of Geography and Statistics (IBGE) indicate that 4% of Brazilians have or have had strabismus. The disability is characterized by any type of misalignment of the eyes, which prevents the vision from focusing on the same point, on the same object. Several factors can cause the injury. Pedro Carricondo, director of Ophthalmology Emergency Care at the Hospital das Clínicas of the Faculty of Medicine of USP, explains that the problem may be related to genetic conditions, changes in the eye, a retinal lesion, a cataract that greatly reduces the vision of one of the eyes and which can lead to strabismus. Neurological causes can also cause muscle changes as a secondary consequence of some type of accident, trauma where some type of fracture has occurred, or the breaking of the bones around the eye, in the region known as the orbit. To make an initial diagnosis, the patient’s history and age are evaluated.
Children and adults present different symptoms. In children there will probably be no symptoms, what happens is that the brain starts to ignore one of the two images and as a result the little ones can develop a relatively serious condition, amblyopia, that is, the failure to develop normal vision in the eye that the brain not using the image. This is called “lazy eyes”, which is amblyopia. If left untreated, until around 8 years of age – the maximum limit -, the child has a great chance of having very reduced vision in the eye that is being diverted. This is strabismus in children.
Adulthood
In adults who were already able to see, when they develop strabismus, they will usually have double vision. This is the most common, most frequent symptom. As a general rule, it is necessary to look for an underlying cause, some neurological factor, for example, thyroid disorder, Graves’ disease. A condition called myasthenia, among many other diseases, may occur. It is possible to divide strabismus: whether the eyes move inwards or outwards or with a height. These are the ways used to classify strabismus. The deviation is not always a visible problem, there may be a small dysfunction that causes changes, especially in children. A very high degree of hyperopia can misalign vision. Carricondo explains that “the eye needs to accommodate, it needs to compensate for this degree and, when it does this, it moves inward at the same time. It is not always necessary to have a muscular problem causing strabismus, it could be a vision problem.”
There are some types of strabismus with genetic characteristics that are inherited, but not all are genetic. However, even though it is not directly genetic, children of parents with disabilities are four times more likely to have the problem. Age and the cause of the disability are relevant when defining the type of treatment which, in most cases, produces positive results for many years. Normally, treatment begins with a patch until the child’s vision develops, and, if the eyes still do not stay aligned, it is necessary to perform surgery, which consists of regulating the muscles, the position of the eyes, realigning them, starting the using both eyes at the same time – in adults it is aligned and they no longer have double vision.
Strabismus, especially in children, deserves special attention from an ophthalmologist, because this is the period to prevent injuries in adulthood. The best way to be successful with children is treatment up to a maximum of 7 or 8 years old. After this age, there is no point in undergoing treatment, highlights Carricondo. This is not just an aesthetic issue, but rather the child’s ability to develop their vision normally.