Strabismus
What is strabismus?
Strabismus - also known as crossed eyes - is a condition in which the eyes are not aligned in the same direction. One eye looks straight, while the other turns inward, outward, up, or down. This is not just an aesthetic problem. The brain that receives two different images may begin to "switch off" the signal from the weaker eye - which in children leads to permanent weakening of vision - amblyopia.
It is estimated that strabismus affects 2 to 4% of the population, and hereditary factors play a significant role - research shows that up to three quarters of those affected have a family member with the same problem.
When does it occur?
In children cases, strabismus most commonly develops before the age of six - as a result of uncorrected refractive errors or disturbances in the brain centres that regulate the position and movement of the eyes.
Convergent strabismus - where the eye turns inward - typically appears before the age of three
Divergent strabismus - where the eye turns outward - somewhat later, between the ages of five and ten
This is precisely why early detection and treatment are crucial - the brain is still developing during this period and can be "taught" to use both eyes correctly.
In adults cases, strabismus can develop as a consequence of disorders of the eye muscles or the nerves controlling them. In this case there is no weakening of vision - but double vision is a frequent and very unpleasant symptom.
If you notice your child turning one eye, squinting one eye, or tilting their head when looking - do not wait. The earlier the diagnosis is made, the greater the chances of full visual recovery.
What are the symptoms?
visibly turning of one eye (inward, outward, up or down)
double vision - especially in adults
tilting or turning the head when looking
squinting or closing one eye in the sun
weaker vision in one eye (amblyopia) - in children
How is it diagnosed?
The diagnosis is made through an ophthalmological examination - including assessment of visual acuity, measurement of the angle of deviation, and evaluation of eye movement. In children it is particularly important to also assess the prescription - as uncorrected hypermetropia often underlies strabismus.
How is it treated?
Treatment of strabismus depends on the cause, type, and age of the patient - and often involves a combination of several approaches:
Prescription correction - glasses are sometimes sufficient to correct the eye position, especially in accommodative strabismus associated with hypermetropia.
Patching (occlusion) - covering the healthy eye with a patch encourages the brain to activate the weaker eye and thus treat amblyopia.
Orthoptic exercises - special exercises that help establish binocular vision and cooperation between both eyes.
Surgical treatment - when conservative methods are not sufficient, surgery corrects the position of the eye muscles. The goal is to position the eye correctly and create conditions for the development of binocular vision.
Frequently asked questions
Can strabismus affect a child's academic performance?
Yes - a child with strabismus may have difficulties reading and concentrating due to impaired depth perception. Early treatment significantly reduces this risk.
Can too much screen time cause strabismus?
Screens themselves are not a direct cause of strabismus. However, prolonged near-distance viewing can strain the muscles responsible for convergence - turning both eyes inward when looking at something close up. In children who are genetically predisposed, this can contribute to the development of convergent strabismus. Regular breaks and limited screen time are recommended - especially for young children.
Both eyes need to work together.
With timely diagnosis, the chances of successful treatment are greater.