Strabismus is the medical term for any form of eye turn. This occurs when the two eyes are not aligned and they do not point in the same location. If the eye turns inward it is called "esotropia" (cross eye). If the eye turns outward it is called "exotropia' (wall eye). If the eye is vertically misaligned it is called a vertical strabismus.
Strabismus can be constantly present or intermittent, it can be found always in one eye (unilateral strabismus) or it may alternate between the two eyes. Strabismus that develops very early in life will result in some form of perceptual adaptation by the brain. The central portion of vision will be suppressed or ignored by the brain, thus avoiding double vision. This typically results in loss of binocular (two eyed) depth perception known as "stereopsis" or 3-D vision.
Amblyopia
Amblyopia is a reduction in the best visual acuity possible for an individual without any apparent disease of the retina, optic nerve, or any other component of the visual system. Amblyopia develops during the "critical period" of vision development (typically prior to the age of 6 to 8 years).
Vision, even with glasses or contact lenses is correctable to levels less than 20/20.
Strambismus & Amblyopia: Diagnosis is Critical
It can not be overstated how important it is to diagnose and treat strabismus and amblyopia as early as possible in a child's life. Constant strabismus is best treated at very early ages in order to avoid the development of amblyopia. For the same reason diagnosis of "anisometropia", or large differences in prescription between the two eyes, is equally important. That is why we strongly suggest that all children are examined by age 3. Screening examinations should be conducted prior to a baby's first birthday.
Treatment of Strabismus and Amblyopia
In strabismus, the first thing required after diagnosis is to get the eyes aligned. This often requires eye muscle surgery. Very early treatment (prior to age 2) is very important in cases of constant esotropia. Prior to and following strabismus surgery patching therapy is often used to stimulate the eye involved (thus reducing the likelihood of developing amblyopia). Many forms of strabismus do not have a risk of amblyopia and actually respond very well to vision therapy (orthoptics or eye excercises). Cases that respond to strabismus vision therapy include intermittent strabismus, alternating strabismus, and exotropia types of strabismus.
In cases of anisometropia, the key therapeutic approach involves equalization of images between the two eyes. This can be achieved with glasses, or preferably with contact lenses. The key issue is that we need to have similar retinal image sizes between the two eyes. With glasses, the greater the difference in prescription between the two eyes, the greater the difference in image size created. This effect is dramatically reduced with contact lenses, and as such, they are the preferred method of vision correction in these cases.
Contact lenses are wonderfully accepted by even the youngest of children when properly fit by our contact lens experts at NSVC. Yes, even babies have been successfully fit in contact lenses when necessary!
Amblyopia therapy highly depends on stimulating the affected eye. This can be achieved with the use of patching or occlusion therapy, penalization eye drops, and with the performance of vision therapy that is geared towards visual stimulation and eye tracking activities of the effected eye.
Early treatment of both strabismus and amblyopia is clearly more effective, however we have been successful in the treatment of both of these conditions in latter years of life! Although strabismus surgery is often required in certain cases, it never fully allows the two eyes to work together normally (i.e. normal binocular vision). Functional binocular vision is best achieved by the performance of vision therapy either in lieu of, or in combination with surgery.
To discuss your eye care further or to schedule an appointment, please contact us: Deerfield (847–412–0311) | Park Ridge (847–823–8283) | Schedule an Appointment Online For emergencies, please call our office for instructions—one of our doctors will respond promptly. |
