Strabismus (crossed eyes): traits

What is strabismus

Strabismus or crossed eyes is a condition when the positions of the eyes are not parallel and they move in different directions. In this condition, one eye is usually forward, but the other eye can see to the side, up, or down.

The cause of crossed eyes (strabismus) is poor control of the eye muscles. That's why one eye will focus in a certain direction, while the other eye looks in a different direction.

Over time, the eye that is weaker and less used will result in the phenomenon of "lazy eye" or amblyopia. This condition has the potential to cause permanent vision loss.

Squints can be treated with the use of special glasses or surgical procedures.

How common is this condition?

Strabismus is an eye condition that is more common in children. About 1 in 20 children develop symptoms of strabismus.

In children, crossed eyes usually appear at birth. However, squints in babies often go undiagnosed until the baby is 3 months old.

Meanwhile, not a few cases of crossed eyes are found in adulthood. Squints in adults can be caused by certain diseases or health problems.

Type of cross eye (strabismus)

Strabismus is divided into several types. The classification of crossed eyes is divided based on the direction in which the eye is looking, including:

• Inward (esotropia)
• Outward (exotropia)
• Upward (hypertropia)
• Downward (hypotropia)

In addition to the direction of eye movement, the types of crossed eyes can also be distinguished based on the frequency of their occurrence and which part of the eye is affected.

The following are some of the most common types of strabismus.

1 . Accommodative esotropia

This type of strabismus is the most common, especially in children 2 years of age or older. Accommodative esotropia usually occurs in people who suffer from hypermetropy or farsightedness.

In this state, one eye is looking forward, but the other eye is moving inward. As a result, the eye requires more effort to be able to focus on seeing objects around it.

Accommodative esotropia can be treated with glasses, but sometimes surgery on the muscles of one eye is necessary to treat this condition.

2 . Intermittent exotropia

This type of cross eye occurs when both eyes cannot move at the same time. One eye will focus on the object or move in a certain direction, while the other eye will move in a different direction.

Intermittent exotropia can occur in people of any age group. Treatment for this condition is usually using glasses, eye exercises, or surgery on one of the eye muscles.

3. Esotropia in infants

Another type of strabismus is infantile esotropia . These crossed eyes are commonly found in babies under 6 months of age. This condition is characterized by both eyes moving inward to the eye.

Inward movement of the eye initially occurs only occasionally, but over time it will be permanent.

Signs & symptoms

What are the signs and symptoms of crossed eyes (strabismus)?

Strabismus is more common in infants, toddlers and children. By 3 or 4 months, your baby's eyes should be able to focus on a close object, with the eyes straight and even. Entering the age of 6 months, babies can focus on seeing distant objects.

However, in infants and children who have crossed eyes, the position of the eyes will experience changes and differences in the direction of motion when trying to focus on certain objects.

Most of the characteristics of strabismus can be felt or seen clearly, but there are also those who experience the symptoms from time to time, such as appearing for some time and then disappearing.

The most common signs and symptoms of starbismus include:

• The position of the two eyes is not parallel
• The two eyes are not looking in the same direction
• Double vision
• Closing one eye while trying to focus on a specific object
• Uncoordinated eye movements (both eyes do not move at the same time)
• Loss of sight

Detecting squints in babies and children may be a little difficult for some parents. If your baby or child often closes one eye or often adjusts the position of his head, you may need to be alert and have your child checked by a doctor.

When should I see a doctor?

This visual disturbance needs to be examined by a doctor immediately. If the child experiences any or all of the above symptoms, immediately consult an ophthalmologist.

You also need to see a doctor immediately if your child shows symptoms, such as:

• Crossed eyes when looking in a certain direction
• The eye feels sore and stiff
• Eyes difficult to move
• Headache every time trying to focus on seeing
• The vision in one eye decreases

Also be aware if the child experiences learning disabilities at school which is caused by the child's inability to see learning material on the blackboard clearly.

Cause

What causes crossed eyes (strabismus)?

In most cases, the cause of crossed eyes is influenced by heredity, so it is also called congenital strabismus. In general, squints are caused by movement of the eye muscles that are not functioning properly.

As described in the American Optometric Association, there are 6 different muscles in each eye. These muscles work together to move the eye. That way, both of your eyes can focus on seeing an object at the same time.

In strabismus sufferers, the eye muscles are unable to work together. As a result, one eye focuses on an object, while the other looks in a different direction.

This causes the retina to send two different signals to the brain. This of course can confuse the brain in processing signals into images. Often times the brain will ignore the signals sent by eyes that are focused and whose movements are weaker.

If this is allowed to continue, the eye that is ignored by the brain may decline in function and gradually lose the ability to see properly. This loss of sight is called amblyopia or “lazy eye”. Amblyopia that occurs first can also be the cause of crossed eyes.

In addition, there are also several health conditions that can cause crossed eyes in children, such as:

• Apert Syndrome (a genetic disorder that affects the growth of the skull)
• Cerebral palsy
• Congenital rubella
• Hemangioma near the eye during infancy
• Incontinentia Pigmenti Syndrome (a rare genetic disorder that affects the skin)
• Noonan Syndrome (a rare genetic disorder that affects facial appearance)
• Prader-Willi Syndrome (a genetic condition that causes weak muscles to form)
• Retinopathy of prematurity (disorders affecting the eyes)
• Retinoblastoma (rare cancer of the retina)
• Traumatic brain injury
• Trisomy 18 (a genetic disorder that causes birth defects)
• Other diseases that cause vision loss

While strabismus that just appears in adulthood is caused by:

• Botulism
• Diabetes (causes a condition called acquired paralytic strabismus)
• Graves' disease
• Guillain-Barré Syndrome
• Injury to the eye
• Cerebral palsy
• Shellfish poisoning
• Stroke
• Traumatic brain injury
• Loss of vision due to eye disease or other conditions.

Risk factors

What increases my risk of getting crossed eyes (strabismus)?

Cross-eyed is a condition that can affect people of all ages and races. However, there are factors that can increase a person's risk of developing strabismus.

Here are some of the risk factors that can trigger this vision disorder:

• Descendants of families who have crossed eyes or other visual impairments
• Genetic disorders that cause vision problems
• Abnormalities in the brain, such as hydrocephalus, Down's syndrome, stroke, brain injury, cerebral palsy , or a brain tumor
• Viral infections such as measles
• Eye disorders such as lazy eye disease (amblyopia), farsightedness, or damage to the retina
• Eye complications of diabetes

Diagnosis

How do doctors diagnose this condition?

Immediately consult a doctor if you or your child has symptoms of crossed eyes. Treatment early can reduce the risk of blindness or permanent vision loss.

In the process of diagnosis, the doctor will perform a physical examination which includes a detailed eye examination. The doctor will check several aspects, such as:

• Test corneal light reflex to check crossed eyes
• Test cover / uncover to find out eye movements and oddities in eye movements
• A visual acuity test to determine how far the eye can focus, can be a refractive test
• Retina exam to examine the back of the eye

If the doctor sees any other accompanying symptoms, the doctor may examine the brain and nervous system. Doctors may suggest undergoing brain tests to confirm this possibility cerebral palsy or Guillain-Barré syndrome.

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the treatments for strabismus?

Treatment for strabismus is aimed at reducing the risk of complications, such as amblyopia or permanent blindness. The sooner the symptoms are treated, the more effective the treatment results will be.

Here are some treatment options for crossed eyes:

• Using glasses or contact lenses, especially if there are other vision problems such as farsightedness.
• The use of prism lenses, which are thicker lenses to reduce eye movement that is difficult to focus on seeing in one direction.
• Use the eye patch that is worn to cover the part of the eye that is functioning best. This is done in order to improve the vision ability of the weaker eye.
• Injection botulinum toxin or botox that is injected into one of the surface muscles of the eye.
• Eye muscle therapy to train visual focus and improve coordination of eye muscle movements.
• Surgery to repair damaged eye muscles by changing the shape or position of the eye muscles. This treatment is also accompanied by eye muscle therapy.

What are some lifestyle changes or home remedies for strabismus?

Here are lifestyle and home remedies that can help you deal with strabismus:

• Eye exercises or exercises are good for strengthening or resting both eyes.
• Wearing an eye patch to cover a properly functioning eye can help weak eyes.
• Always use visual aids either glasses or contact lenses to see clearly.
• Overcoming chronic stress experienced.
• Exercise and maintain a healthy diet, especially for eye health.