Strabismus: Causes, Diagnosis and Treatment of Lazy Eye

In babies or children, strabismus is one of the most frequent optic conditions. About 4% of children under the age of 9 have a deviated eye. The most severe consequences have to do with reduced brain development, learning and knowledge, as well as loss of vision.

What is strabismus in children?

In technical terms, strabismus is the result of the malfunctioning of the binocular functions. The use of sight involves two functions, one being binocular and the other, monocular. Both functions develop from birth and continue to mature until a child is eight or nine years old.

With strabismus, the binocular function is damaged, meaning that both eyes are unable to focus on the same object. As a result, information reaches the brain in a confusing manner.

The response of the central nervous organ is to disregard images that are less sharp. In this way, the body resolves and avoids double vision, or diplopia.

Just the same, the eye that is misaligned will continue sending images to the brain. However, and as a result of its vain insistence, it’s likely that the eye will eventually become “lazy”, suffering irreparable loss of vision development.

Causes of strabismus in children

Among the most common ophthalmological causes, we can mention the following:

• A malfuncion of optical nerve control.
• Retractive defects such as farsightedness.

Other causes of lazy eye in children:

• A collapse of the nervous system as a result of certain illnesses, high fever, or a high-stress situation.
• At the same time, strabismus in children can occur as the results of other conditions, such as cerebral palsy or hydrocephalus. Complications such as premature birth can also lead to strabismus. At the same time, children with Down Syndrome are also prone to suffering strabismus.
• It’s important to mention as well that there is a certain genetic predisposition when it comes to strabismus.

Types of lazy eye

The symptoms of this functional abnormality usually appear in childhood. However, it’s important to know that strabismus can also arise during adulthood. Not all cases of strabismus are alike. 

1. Unilateral strabismus and alternating strabismus. In the first, the fixed eye monopolized the visual field. In the second variety, both eyes take turns sending messages to the brain, providing for homogeneous development of both eyes.
2. Intermittent strabismus. This occurs only in certain circumstances (illness, stress). It can also appear only when an object is at a certain distance (close, medium, far).

According to the direction of the lazy eye

• Extotropia. Outward or divergent misalignment, where the eyeball points outward.
• Esotropia. Inward or convergent deviation, where the eyeball points inward. This is the most common type of strabismus.
• Hyperotropia. When one eye’s gaze points higher than the other.
• Hipotropia: When one eye’s gaze points lower than the other.

Diagnosis of strabismus in children

Lazy eye in children is difficult to prevent. However, early detection and treatment can mean preventing the inconveniences and consequences of strabismus, and even the reversing the malfunction. The eye exam recommended at 3 years of age is fundamental for children with this issue.

If a pediatrician notices an abnormality in your child’s eyes, then you should consult with an ophthalmologist right away. If a family history of strabismus exists, then you should take your child to see an eye doctor before the age of 3.

Treatment of strabismus in children

Treatment varies according to the condition the eyes are in and the degree of deviation. The objective will be to restore binocular vision. Depending on the case, treatment can range from prescription glasses to surgery. Doctors may also use patches to strengthen the weaker eye.

The treatment applied in cases of accommodative strabismus is known as optical correction. Here, it’s common for patients to use glasses or contact lenses. In cases of visual therapy, doctors use exercises and mainly patches.

In some cases, surgery is required. The surgeon will make a tiny incision in the tissue covering the eye in order to reach the muscle.

Depending on each case, the surgeon will need to reposition the muscles in one or both eyes. The procedure is relatively simple and children will soon be able to go back to playing without any issues.