Alternating strabismus is a fairly common defect among children and adults. This is not only an aesthetic defect or a cosmetic defect, but a truly serious disease that develops for many different reasons. Treatment for alternating strabismus should begin when the first signs appear. Otherwise, the patient runs the risk of completely saying goodbye to vision.
general information
The code for friendly convergent strabismus according to ICD-10 is H50.0.
Strabismus is a disorder in the work of the eye muscles. There are many varieties of this pathology, which differ in their localization and degree of complexity. An important condition for proper treatment is the establishment of a correct diagnosis.
Alternating strabismus is a form of friendly strabismus, which is characterized by alternating deviation of the eyes from the central axis. The main prerequisite for the development of pathology is considered to be a violation of the functioning of the muscles of the visual apparatus. Most often, the disease originates in childhood.
Causes
Treatment of strabismus in children and adults only partially depends on the initial prerequisites for the development of pathology. After all, the pathogenesis of strabismus has not yet been studied. True, doctors mention a hereditary factor in the etiology of pathology. It is genetic defects that can become the catalyst for the onset of eye disease.
The chances of developing alternating strabismus in a child, just like any other of its forms, increase significantly if a woman, being in a position, smoked, abused alcohol or took powerful analgesic drugs. Another reason for the appearance of strabismus is considered preterm birth.
If the disease is acquired in nature, then it manifests itself almost imperceptibly and gradually.
The most common causes of friendly strabismus are:
- myopia;
- benign and malignant neoplasms;
- myopia;
- myasthenia gravis;
- cataract;
- constant stress;
- farsightedness;
- astigmatism;
- thorn;
- optic atrophy;
- damage to the visual system and paralysis;
- retinal disinsertion.
Adults are exposed to the disease most often due to the introduction of infection into the body and against the background of received eye injuries.
Clinical picture
Converging alternating strabismus most often occurs in childhood. It may be inconsistent in nature until the visual apparatus begins to exclude the picture falling into the field of a mown apple.
Over time, the brain gets used to the fact that images visible with two eyes interfere with each other in creating a single object. As a result, visual analyzers simply stop responding to pictures coming from a diseased nerve.
Gradually, vision becomes monocular, and the pathology itself becomes more pronounced and constant. Unstable convergent alternating strabismus is quite often accompanied by medium or high farsightedness. Its origin is characteristic of early childhood and the neonatal period.
If strabismus is triggered by paralysis, there is a slanting of only one eye, which is either completely motionless or its muscles partially move. This clinical picture has many signs:
- binocular vision is impaired;
- there is double vision;
- chronic dizziness;
- the head involuntarily turns towards the paralyzed muscles.
Converging paralytic strabismus (according to the ICD-10 code above) is often the result of background pathologies, harmful factors or damage. This kind of strabismus can develop at any age. The cause of the paralysis of the muscles of the visual apparatus may be intoxication of the body.
Signs
Alternating strabismus is accompanied by the appearance of such symptoms:
- diplopia;
- impaired coordination;
- Dizziness
- migraine;
- decrease in visual acuity.
Pathology progresses with age. Congenital anomaly manifests itself, as a rule, in 2-3 years. Treatment of pathology begins with the use of conservative medicine. The disease is directly related to the functioning of the brain.
Classification
Strabismus may occur periodically or may have a permanent character. In some cases, pathology occurs in stressful situations. And after the disappearance of the stimulus, the problem also passes.
Alternating strabismus is convergent and divergent. In addition, doctors distinguish:
- the latent variety, which is characterized by activation with the exception of the diseased eye from the visual act;
- imaginary pathology, which is due to the peculiarities of the anatomical structure of the skull and the placement of the orbits, usually the disease goes away with age;
- paralytic form, which appears due to malfunctioning of the oculomotor muscles.
The causes of the divergent type of strabismus are:
- differences in level of vision;
- pathology of the retina or optic nerve;
- tumors in the area of the brain, hearing aid, eyes or paranasal sinuses;
- malfunctions of the central nervous system.
How to identify such strabismus? A symptom of vice is the direction of one eye toward the nose when looking at a specific object. It is noteworthy that at the same time his muscles do not lose mobility. In addition, with this pathology, diplopia does not occur.
A convergent type of strabismus is usually accompanied by farsightedness. Doctors distinguish several varieties of this disease:
- the congenital type is detected up to six months, with it, as a rule, wait-and-see tactics are recommended;
- the acquired form is usually diagnosed in children under three years of age;
- monocular defect - with it, only one eye squints;
- an alternating variety affects both eyes;
- paralytic appearance appears against the background of injuries to the brain, muscles or nerve.
The prognosis for such a disease is favorable, but in itself it will not disappear. In the absence of suitable treatment, converging strabismus can lead to a number of complications:
- mental retardation;
- amblyopia;
- visual impairment.
Diagnosis and treatment
The patient can determine the external signs of alternating strabismus on his own. After a visual examination, an ophthalmologist determines refraction and visual acuity, due to which a variety of pathology can be identified. Using echobiometry, you can measure the length of the apple. And its mobility and deflection angle are revealed by the Hirschberg technique.
Correction of strabismus requires an integrated approach and a long therapeutic course. In this case, treatment is mainly directed to the normalization of binocular vision. As a rule, regeneration is carried out when the central nervous system is still able to control the sensory and motor function of the visual organs.
You can get rid of the pathology with the help of such therapeutic and preventive measures:
- avoid infections and damage;
- use of special glasses;
- diploptic exercises;
- control the load on the visual apparatus, the choice of lighting;
- occlusion;
- surgical intervention.
Hardware therapy
For the treatment of alternating strabismus, specialists use the synoptophore device. Its main task is to combine the picture together. The device is used:
- to determine the strabismus angle and the product of all necessary measurements;
- diagnosing the general state of health of the retina;
- binocular vision tests.
As already mentioned, the causes and treatment of strabismus in children and adults are directly related. Thanks to this apparatus, it is possible to identify the prerequisites that influenced the development of the disease.
With the help of a synoptophore, various abnormal processes can be detected:
- functional scotoma;
- fusion pathology;
- a compound of a non-fial form.
Treatment for convergent strabismus
Visual abilities are finally formed, as a rule, by 25 years. That is why therapy with alternating strabismus is carried out until this age. Several treatment methods are used:
- Pleotic therapy. Through special computer technology or a laser, stimulation is performed that helps to artificially increase the load on the damaged eye.
- Orthopedic method. Special computer programs and synoptic devices contribute to the normalization of binocular vision.
- Occlusion.
- Correction with special glasses.
All these therapeutic procedures are aimed at the regeneration of visual acuity, the restoration of connections between the eyes, the activation of the oculomotor muscles and the proper placement of apples.
Treatment for divergent strabismus
The fight against anomaly consists of a whole range of therapeutic measures:
- optical correction - the use of special glasses or plastic lenses;
- hardware treatment increases visual acuity;
- diploptic technique that improves binocular vision;
- surgical intervention.
As for outpatient therapy, it is used only in the initial stages of the development of pathology. Home treatment comes down to strengthening the oculomotor muscles. Many patients use traditional medicine recipes to correct vision.
Surgical intervention
Alternating strabismus rarely causes complications, but if conservative methods do not bring the desired result, the patient is shown surgical correction. It is needed if, due to strabism, vision begins to deteriorate or other problems appear.
If we are talking about a small child, then the optimal age for surgery is 2-3 years. As a rule, there are no problems with recovery and by the age of 6-7 years, vision becomes normal.
The operation is performed under local anesthesia, only occasionally - under general. To strengthen the oculomotor muscles, they are shortened.
Recommendations
The rehabilitation period takes about a week. All sorts of physical activities are prohibited during this period, and special eye drops are used to prevent complications.
For a month after surgery, you can not visit the solarium, pool, sauna or swim in open water. But it is worth noting that the operation is not a panacea for alternating strabismus. In other words, after surgery, the prescribed therapeutic measures should be continued. For example, wearing glasses, applying eye drops and gymnastic exercises.