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What is Strabismus?
Strabismus is the medical term also known as ‘a squint’ in the UK and often referred to as ‘crossed eyes’ in the US. It’s a visual condition in which the eyes are misaligned and do not point in the same direction. In strabismus, one eye may look straight ahead while the other eye may turn inward, outward, upward, or downward.
With strabismus, each eye is taking quite different points of view. This means the brain can have difficulty ‘matching’ these to form a picture, which can result in blurred or double vision.
This misalignment can lead to problems with depth perception, and can cause the brain to suppress or ignore the input from the misaligned eye, which can eventually lead to amblyopia or "lazy eye."
Strabismus can be caused by a variety of factors, including problems with the muscles that control eye movement, nerve problems, or a combination of both. Treatment options for strabismus include glasses, prisms, vision therapy, and surgery to realign the eyes. Early detection and treatment of strabismus is important to prevent vision problems and other complications.
"Most strabismus develops in young children. Strabismus can also develop in adults, but an adult will develop strabismus for different reasons than a child."
Symptoms of Strabismus
The most noticeable symptom of strabismus is the misalignment of the eyes. Depending on the type of strabismus, the eyes may appear to be crossed, turned outward, upward or downward. Other symptoms of strabismus may include:
Double vision
When the brain receives two different images from each eye, it may perceive double vision.
Head tilting or turning
To compensate for the misalignment of the eyes, some people with strabismus may tilt or turn their head in a certain direction.
Eye strain or fatigue
People with strabismus may experience eye strain or fatigue, particularly when performing visually demanding tasks such as reading or driving.
Difficulty with depth perception
Squinting or closing one eye
If you or someone you care for is experiencing any of these symptoms, it's important to see a qualified optometrist or ophthalmologist for an evaluation.
Early diagnosis and treatment of strabismus can help prevent further complications and improve vision.
How someone with Strabismus might view the world
Please note this is a simulation of strabismus, based on the anecdotal experiences of people who have the condition.
This image is not the experience of everyone with strabismus and is for illustration purposes only.
Diagnosis of Strabismus
Strabismus can be diagnosed through a comprehensive eye examination, performed by an optometrist or ophthalmologist, or a specialist in strabismus. The examination may include:
A visual acuity test
This measures the sharpness of vision in each eye using an eye chart.
A cover test
This test involves covering one eye at a time while the patient focuses on an object. The doctor will observe whether the covered eye moves to focus on the object when uncovered, which can indicate a misalignment.
An eye movement test
This measures the ability of each eye to move in all directions, and can detect problems with eye coordination.
Refraction test
This measures the refractive error (i.e. short / near sightedness, long / far sightedness, or astigmatism) of each eye and determines whether corrective lenses are needed.
Pupil response test
This measures the reaction of the pupil to light, and can detect abnormalities in the eye muscles or nerves.
Binocular vision assessment
This evaluates how well the two eyes work together to perceive depth and alignment.
In some cases, additional tests such as imaging studies or specialised eye tests may be needed to further evaluate the condition. Once a diagnosis of strabismus is made, appropriate treatment can be initiated to correct the alignment of the eyes and prevent further vision problems.
"Strabismus usually develops in infants and young children, most often by age 3."
American Optometric Association
Treatment of Strabismus
The treatment of strabismus depends on the severity of the condition and the underlying cause.
Treatment options for strabismus may include:
Glasses or contact lenses
Corrective lenses can help improve vision and eye alignment in some cases of strabismus.
Vision therapy
This is a type of eye exercise program that can help improve eye coordination, visual processing, and eye movements.
Patching therapy
Patching therapy involves covering the 'good' eye with an eye patch to force the brain to use the misaligned eye, which can help improve visual acuity in the weaker eye.
Prism glasses
Special glasses with prism lenses can be used to redirect the light and help improve eye alignment.
Surgery
In some cases, surgery may be recommended to correct the alignment of the eyes. This may involve tightening or loosening the muscles that control eye movement.
The most appropriate treatment option for strabismus will depend on the type, severity, and underlying cause of the condition.
It's important to consult with an optometrist or ophthalmologist or a specialist in strabismus to determine the best course of treatment for each individual case. Early diagnosis and treatment of strabismus can help prevent vision problems and other complications.
"The prevalence of strabismus is between 2% and 5% of the general population".
Living with Strabismus
Most people lead full and independent lives while living with strabismus. There are of course challenges to living with strabismus, though there are steps that can be taken to manage the condition, minimise its impact and improve quality of life.
Here are some tips for living with strabismus:
Seek treatment
If you have strabismus, it's important to see an optometrist, ophthalmologist or a specialist in strabismus for a comprehensive eye examination and appropriate treatment. Early diagnosis and treatment can help prevent vision problems and other complications.
Wear corrective lenses
If you have a refractive error which means you are short-sighted (nearsighted), long-sighted (farsighted), or have astigmatism, wearing corrective lenses can help improve vision and eye alignment.
Practice good eye health
Maintaining good eye health is important for people with strabismus. This includes getting regular eye exams, protecting your eyes from injury, and avoiding activities that can strain the eyes.
Use assistive technology
Assistive technology, including screen magnifiers, screen readers and accessible book readers and text-to-speech software, can help you navigate your daily life. These tools can make it easier to read, write, study and use technology.
Whatever your experience is with computers, Dolphin assistive technology can help.
Develop coping strategies
Living with strabismus can be challenging - especially if it affects self-esteem or social interactions. Developing coping strategies such as positive self-talk, relaxation techniques, and seeking support from family and friends can help.
Avoid triggers
Some people with strabismus may experience symptoms such as eye strain, double vision, or fatigue in certain situations. Avoiding triggers such as bright lights or reading in dimly lit areas can help reduce these symptoms.
Consider vision therapy
Vision therapy is a type of eye exercise program that can help improve eye coordination, visual processing, and eye movements. It may be recommended by your optometrist or specialist in strabismus.
Help educate others
It's important to educate others about strabismus to help reduce stigma and promote understanding. Letting people know about the condition and its effects can help foster empathy and support.
Living with strabismus may require some adjustments and accommodations, but with appropriate treatment and support, most people with strabismus lead full and fulfilling lives.
