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How to treat strabismus

Strabismus or squinting is a condition in which the eyes do not properly align. Normally, both eyes look into the same direction. In the event of strabismus, the eyes look in different directions.
Strabismus examination children

Strabismus investigation

Strabismus does not cause any pain, which is why squinting becomes obvious mainly by the misalignment of the eyes. Additionally, a poor eyesight might develop. Often, three-dimensional vision is affected. Therefore, treating strabismus is advisable not only because of cosmetic reasons but of medicinal reasons as well. A factor that should not be underestimated is the physical stress which might lead to low self-esteem and a lack of confidence. However, thanks to modern medical methods, strabismus can be treated and the result is usually satisfactory in almost all patients. The treatment aims at preventing poor eyesight and reducing the squint angle so that both eyes are almost parallel.

Non-operative treatment methods

The most commonly occurring form of strabismus is infantile squinting. The so-called concomitant squint occurs most commonly in the first four years of life. The eye muscles are functioning properly but the squinting eye accompanies the movement of the healthy eye. Thanks to the good treatment options, the aim is to remove the misalignment of the eyes without surgery.

  • In order to treat poor eyesight, it is advisable to consult an optician and to purchase glasses. For heterophoria, i.e. a slight misalignment of the eyes, wearing glasses is sufficient for two thirds of the persons affected.
  • Occlusion therapy is another option. One eye is covered with a pad. If only one eye is misaligned, the stronger eye is covered with an eye pad. This way, the weaker eye is forced to enhance its eyesight. When treating adults, one lens of the glasses is often covered with a matt film to prevent double vision. The eyes can also be treated not to perceive double vision with a special training 

Strabismus surgery

If these measures do not show any success, surgery of the eye muscles is an option. A therapy to improve eyesight usually precedes the decision for surgery. The aim of the surgery is to establish or reestablish the basis for binocular vision. Physical stress can also be a reason for surgery. The surgery is supposed to correct the squint angle and to reestablish alignment of the eyes. For children, the surgery is often conducted under general anesthesia. For adults, local anesthesia is usually sufficient. Surgical procedure is also possible for toddlers.

A special form of strabismus is paralytic strabismus, which mainly occurs in adults. Paralytic strabismus is caused by a paralyzed eye muscle and, depending on the exact cause, may fade on its own after several weeks or months without any treatment procedures. In some cases, however, paralytic strabismus does not go away on its own and therefore needs to be treated with one of the above-described therapies or via surgery.

It should be discussed with a specialist for ophthalmology or a similarly qualified specialist whether glasses prescription, occlusion therapy, surgery or any other treatment method is best suitable. In general, it can be stated that the sooner the strabismus is treated, the quicker and more reliable the improvement of eyesight and the alignment of the eyes can be achieved. Hence, in the event of strabismus, an ophthalmologist or eye clinic should be consulted immediately.