It is present in around three per cent of children. If strabismus is left untreated, it can cause vision loss in about half of children. This is due to amblyopia, which is the reduction in the eye's visual acuity function.
There are several types of strabismus, including: a tropia, a manifest deviation which can be detected with both eyes open, and can involve one or both eyes; a phoria, a latent deviation that can be detected when covering one eye; a comitant deviation, which has the same misalignment degree or amplitude in all directions of your gaze; and an incomitant deviation, which varies in misalignment degree or amplitude, according to the direction of your gaze.
Causes of strabismus in children
The causes of strabismus in children include muscle imbalance, refractive error, and other rare causes such as ocular defects, retinoblastoma and neurologic disease.
Strabismus can either be acquired or present from an early age (infantile).
Children may be more likely to have infantile strabismus if: the condition runs in their family; they have had prenatal drug exposure; they have a genetic disorder such as Crouzon syndrome or Down syndrome; they have cerebral palsy, they have a congenital eye defect; they were born prematurely; or they had a low birth weight.
Treatment of strabismus
Strabismus in children is typically diagnosed via; eye tests, such as alternate cover, corneal light reflex and cover-uncover; physical and neurological exams; and prisms, which are used to measure vertical and horizontal deviation.
Treatment of strabismus aims to equalise vision and then align the eyes.
The main objective of strabismus treatment is to equalise the vision and align the eyes. Treatment options for children with strabismus can include: glasses or contact lenses for refractive error; patching or atropine to address attendant amblyopia; eye exercises to address convergence insufficiency; and surgical eye alignment.
Surgery
For cases in which non-surgical treatments have proven ineffective, surgical repair can be considered to align the eyes more satisfactorily. Surgical procedures usually focus on resection (tightening) and recession (loosening). They are typically conducted bilaterally and involve the horizontal rectus muscles. Procedures usually involve altering the length of the eye muscle or changing its insertion position, before it is sewn to the eye wall.
Surgical repair has a relatively high success rate - satisfactory alignment is achieved in over 80 per cent of patients.
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