Tsstrabismus

Anyone older than four months of age who appears to have strabismus should have a complete eye examination by a pediatric ophthalmologist, with extra time spent examining how the eyes focus and move. The exam may include the following:

Patient history (to determine the symptoms the patient is having, family history, general health problems, medications being used and any other possible causes of symptoms)

Visual acuity (reading letters from an eye chart, or examining young children’s visual behavior)

Refraction (checking the eyes with a series of corrective lenses to measure how they focus light). Children do not have to be old enough to give verbal feedback when checking for glasses.

Alignment and focus tests

Examination after dilation (widening) of the pupils to determine the health of internal eye structures

Treatment options include the following:

Eyeglasses or contact lenses: Used in patients with uncorrected refractive errors. With corrective lenses, the eyes will need less focusing effort and may remain straight.

Prism lenses: Special lenses that can bend light entering the eye and help reduce the amount of turning the eye must do to look at objects.

Orthoptics (eye exercises): May work on some types of strabismus, especially convergence insufficiency (a form of exotropia).

Medications: Eye drops or ointments. Also, injections of botulinum toxin type A (such as Botox) can weaken an overactive eye muscle. These treatments may be used with, or in place of, surgery, depending on the patient's situation.

Patching: To treat amblyopia (lazy eye), if the patient has it at the same time as strabismus. The improvement of vision may also improve control of eye misalignment.

Eye muscle surgery: Surgery changes the length or position of eye muscles so that the eyes are aligned correctly. This is performed under general anesthesia with dissolvable stitches. Sometimes adults are offered adjustable strabismus surgery, where the eye muscle positions are adjusted after surgery.