Strabismus in a child is a pathological problem with vision, in which the position of the eyes is broken relatively anatomically correct. There is a deviation from the axis of view. A child cannot simultaneously focus both eyes on one object of study, which prevents binocular vision inherent in a healthy person. Statistics show that strabismus is observed in almost 3% of children on the planet. It was not possible to identify gender dependency; equally, the problem can haunt both boys and girls.
general information
It is possible to notice strabismus in a child if one eye (and sometimes both at once) deviates relative to the normal position. Another option for the development of pathology is the immobility of one eye. Usually, children suffering from such a violation often squint, bow their heads, reflexively trying to smooth out the imperfection of the visual organs.
Some believe that the described complexity is nothing more than cosmetic, but such an opinion is fundamentally wrong. Strabismus in a child indicates improper functioning of the visual system, and violations simultaneously affect several elements. In total, all this provokes quite serious difficulties with health.
When a healthy child examines an object, a picture is instantly fixed in both eyes on the retina, and it is located strictly in the central zone. This is due to focusing on one point. Such images, when processed by the brain, are superimposed one on top of the other, which allows you to get a complete picture of the world around you. Strabismus in a child becomes the reason for entering different parts of the brain responsible for the vision of different images, since each eye focuses on its object. Therefore, the merger becomes impossible, the central nervous system does not perceive the information received, thereby preventing double vision. Instead, information is read from only one eye. Over time, this leads to atrophy of the eye muscles of the eye, on which there is no load, which means that vision weakens, amblyopia is diagnosed. Children with strabismus are much more susceptible to this disease than those who have no problems with focusing their organs of vision on one object.
About terminology
Amblyopia is a term used to describe the situation of the impossibility of the mutual work of the cerebral cortex and the eye retina. With amblyopia, the body simply cannot process the information coming from outside in the form of a visual series.
Should I worry?
Despite the stereotypes, amblyopia and strabismus in children is really a big problem requiring early intervention. It is not only the damage to the organs of vision, but also the mental abnormalities that occur in sick children much more often. The complexity of vision has a serious impact on the psyche, depressing the child, preventing him from developing. Mostly children suffering from such difficulties are closed, unsure of themselves, others are aggressive and look at everything too negatively. For most strabismus, an inferiority complex is characteristic.
The problem is different
It is customary to distinguish three forms:
Doctors diagnose strabismus. As a rule, the diagnosis is made at the age of over two, but less than three years old, if at this point the eyes do not begin to function in a coordinated manner. As follows from statistics, reviews, strabismus in children is most often observed precisely in this period. This is due to the specifics of growing up: closer to the age of three, babies become active, study the world around them, and this requires attention and tension of the visual organs.
Toddlers and Older Kids
As a rule, problems with focusing eyes in infants are observed. The causes of strabismus in children under one year of age are simple - lack of formation of the visual apparatus, lack of work of the analyzer. Until the age of two months, and sometimes twice as much, the eye muscles still simply cannot work in coordination. If parents note strabismus in a child precisely at the first stages of life, it is too early to panic. But if after four months the situation has not improved, then you need to visit a doctor.
As a rule, when asked about why a child has strabismus, the doctor will answer only by conducting preliminary studies. It is highly likely that the cause is congenital. Clarification of the situation is carried out on a routine examination. It is necessary to show the child to the doctor at the age of one month, six months and one year. Further, the frequency of visits to the ophthalmologist is once a year or twice if no problems are identified. But if, for example, inconsistent strabismus is found in children, then visits will have to be increased.
Establishing diagnosis
You should not try to understand at home whether the child is healthy, what kind of problems he has, if something seems wrong. Only a doctor knows how to determine strabismus in a child, what to do if the diagnosis is confirmed. At the child’s reception, they will check according to a special technique, making a series of tests. Conclusions allow us to understand exactly what strabismus had to face - true, false. If disturbances in eye movement are clearly visible, a pathological condition can be diagnosed.
In practice, very often the suspicion of strabismus arises in parents whose child has an asymmetrical face. This is nothing more than an imaginary ailment that does not require treatment of strabismus in children. Reviews of doctors about problems of the visual organs in children contain references to the peculiarities of imaginary strabismus. In this condition, the analyzers are absolutely operable and operate in accordance with biological standards, and the apparent disturbances are explained either by different eye slots, or by the anatomical features of the eyelids. From the side it looks as if one pupil (sometimes both) squint. This problem is aesthetic in nature, does not require specific medical care.
The third form of strabismus is hidden. The peculiarity of the condition is the insufficient development of the muscle fibers of the organs of vision. When a child examines an object with two eyes at once, it is impossible to see from the side that the pupils work inconsistently. But if you close one eye, the second will start to mow.
Where did the trouble come from?
Before deciding whether strabismus is treated in children, one should find out what triggered the vision problem in a particular case. There are two options for pathology:
Cross-eyed child can be born due to a genetic factor. The following can provoke an ophthalmic problem:
- improper development of the nervous system;
- Louis Bar syndrome, Brown.
Often it is necessary to understand how to correct the squint in a child, mothers who during pregnancy experienced difficult situations that affected the fetus. Pathological processes obtained during the birth of an injury, suffocation, hypoxia - all this can provoke a malfunctioning of the visual system.
Factors contributing to the acquisition of strabismus:
- disorders of the nervous system, sites responsible for the coordination of eye movements, due to infection, injuries;
- myopia, hyperopia, dystrophic processes, cataract and other diseases of the visual organs;
- neoplasms;
- violation of the integrity of the cerebral cortex, pituitary gland;
- stress, fear, neurosis;
- malfunctioning of the thyroid gland.
The main task of parents is to protect the child from illnesses, nervous shocks, strong feelings, since all of them can have an unforeseen effect on health.
Strabismus: what happens?
A rather complicated classification system was adopted, taking into account several features of the problem. Each type requires its own approach that determines what to do. Strabismus in children by the origin of the problem happens:
The first is diagnosed if only one eye suffers, and the limited ability is due to improper functioning of muscle fibers. In such a situation, the complete immobility of the sick eye is possible. The friendly version is diagnosed if, alternately, one or the other eye deviates from the correct visual axis, while the angle is approximately equal. In practice, it is this form that occurs most often, it is with it that anxious parents who do not know how to cure strabismus in a child turn to doctors.
Based on how much the visual system suffers from pathology, it is customary to distinguish cases:
The first option is expressed by strabismus for only one half, in the second case both eyes are involved.
Based on stability, cases are divided into: inconsistent strabismus in children, permanent. The second option worries all the time, the baby’s condition or external conditions in no way affect the features of the perception of the world through the organs of vision.
Another type of classification involves taking into account the type of deviation. A mixed form is possible in which two or three variants of violations are observed simultaneously, or separately:
- vertical strabismus, when the problem is observed along the vertical axis;
- converging, in which the gaze is always directed to the bridge of the nose;
- diverging when the pupils are directed toward the temples.
Converging is more often diagnosed in farsighted children, and diverging in nearsighted children.
Finally, the latter type of classification takes into account the degree of deviation. Violations not exceeding an angle of 5 degrees are assessed as minimal, small ones - up to 10 degrees, medium - twice as much, and high - up to 36 degrees. If the deviation exceeds this boundary, the case is rated as very severe.
Friendly strabismus: features
Within this group of diagnoses, accept several subtypes. Only the doctor knows how to determine whether the strabismus in a child has developed according to which of these three scenarios. Common groups for dividing cases:
- accommodative strabismus;
- partial accommodation;
- not accommodative.
The accommodation room is usually formed at an age close to three years, and other vision problems become factors that stimulate it. When telling how to cure strabismus in a child in this form, the doctor usually recommends choosing the right glasses. This correction method is the simplest and most widespread.
Partial accommodative strabismus is usually formed at an early age - from one year to two years. To correct the problem, the child is prescribed special lenses. You can achieve a complete cure, but you have to do the operation.
Strabismus in a child of a non-accommodative type can form at any time, there is no link to age. The only treatment is surgical. Other therapeutic approaches do not show results.
As can be seen from the statistics, most often children need treatment for divergent strabismus of an unstable type or wandering. The first option is expressed by the orientation of the pupils towards the temples, which is especially noticeable when the child tries to focus on the object of study. At the same time, vision is generally pretty good. Wandering strabismus proves to be an adequate work of the visual organs separately, while the information about objects is read by the analyzer of only one eye, but the second at a particular moment is simply "turned off".
Visit to the doctor: what does it look like?
Only a doctor can say whether strabismus can be cured in a child in a particular case or not, what methods you need to use, what procedures to go through to achieve a result. True, before understanding the methods of eliminating the problem, it is necessary to confirm the fact of its existence. To do this, do tests to establish the features of the functioning of the analyzers of the visual system. The doctor conducts:
- examination of the patient;
- assessment of visual acuity;
- perimetry, during which it determines what are the fields perceived by the patient;
- study of the bottom of the eye;
- four-point color test;
- checking the amount of mobility of the organs of vision.
The flow test allows you to understand whether a child uses one eye or two to see the world around him. During the volume check, the doctor observes the baby, in front of which the object moves from side to side, down and up.
If there are doubts about the diagnosis, the child is sent for additional instrumental examinations:
In some cases, it is necessary to obtain the conclusion of a neurologist, endocrinologist.
What to do?
Only a doctor can tell exactly how to deal with a problem in a particular case. Much depends on the age of the child, the mechanisms that led to strabismus, the specifics of the case, individual indications and contraindications. The basic rule is to start therapy immediately, barely able to confirm the presence of vision problems. Trouble will not go away on its own, but the early start of the fight against it will help to quickly defeat the defect with minimal negative consequences.
To determine the appropriate course, the doctor conducts a detailed diagnosis and collects a medical history. In some cases, it will be enough to use corrective lenses, in others - to do special exercises, and only surgery for strabismus will help someone. In children, treatment is started, realizing what causes the visual system to become difficult — it is their elimination that becomes the starting point of the course.
Key Approaches
There are two options in all - surgery and non-surgical treatment. One effective, yet safe, approach is direct occlusion. The doctor determines which of the eyes is healthy, and blocks it for a while. To increase the effectiveness of this effect, therapeutic measures are prescribed to reduce discomfort and weaken the visual defect. The doctor selects a set of exercises for strabismus in children. Indirect occlusion often helps eliminate the need for surgical interventions.
Doctors say that non-surgical approaches to treating strabismus are most effective if the deviation is estimated at 10 degrees or less. If the situation is worse, the case is badly launched, you should not waste time. Here, surgery is indicated for strabismus in children, and all other measures only complement it.
Reasons and treatment
A therapeutic approach is chosen, evaluating how far the progress of the disorders has gone. If the stage is initial, the use of special drops is usually sufficient. Also, with strabismus, glasses and lenses are prescribed. From two to four times a year, you will have to go to an ophthalmologist to check how sharp the vision of a sick child is, how the condition progresses.
In addition, resort to:
- direct occlusion method, temporarily limiting the child’s ability to see a normally functioning eye (this turns the diseased eye into a leading one and stimulates improvement);
- hardware treatment by stimulating the retina with light pulses (the most common are laser devices);
- gymnastics.
Exercises are chosen by the doctor, focusing on individual characteristics. A poorly selected complex can significantly impair vision. The benefits of gymnastics will only be with regular practice.
The operation is scheduled!
Most often, surgery is prescribed if a paralytic form is established. The need for an event dictates a deviation from the axis of view by 10 degrees or more. First, the child is prescribed glasses or lenses, prescribed gymnastics and other approaches are practiced, but if they are ineffective, they decide on the need for a cardinal intervention.
If the case is severe, the treatment is two-stage. This is necessary if strabismus simultaneously impairs the function of two eyes. First, they operate on one side, after six months they perform an operation in the second half. A two-stage intervention is necessary if the deviation from the visual axis exceeds one third of the right angle.
As part of the operation, the main task of the doctor is to change the configuration of the eye muscles, reducing them or lengthening. As practice shows, many parents have a negative attitude to the doctor’s proposal to send the child for surgery, fearing that this will only worsen the condition. In fact, much more dangers are associated with the rejection of surgery than with such an intervention. Modern doctors have access to the latest technology, equipment, so events are carried out with minimal damage to healthy tissues.
Features of surgical techniques
The safest and most effective approach is radio wave surgery. The event does not require incisions, which means that the eye will not get injured, the structure will remain intact.The duration of the rehabilitation period with this method is minimal, as are the restrictions on the activity of the child recovering from the intervention. From the hospital a minor patient is discharged on the next day after the event.
It is allowed to carry out an operation to eliminate strabismus from the age of four. It is occasionally recommended that the operation be done earlier - from the age of two to three, but this is only possible with a congenital form. After the intervention, the recovery period begins, coupled with conservative methods of treatment.
I do not want to go to the hospital!
It so happened that many do not trust medicine too much, preferring to treat any health problems at home. You need to understand that no traditional medicine methods will help with strabismus. The only way to defeat a pathological condition is to seek the help of a qualified doctor in time and carefully follow his advice. Attempts to cure difficulties with the eyes with one's own strength only lead to active progress in the condition, and an early deterioration in the ability to see. It is very difficult to cure a child in such a situation, the probability of irreversible violations is high.
Prevention
You can prevent the development of strabismus if you follow the child and adjust the environment and habits in time. Unfortunately, this will not help prevent the congenital form, but the risk of acquired will significantly reduce. Basic Rules:
- not to place static objects near the child’s bed, curious for the baby, capable of attracting his attention for a long time;
- placing a crib in an area that can be approached from different sides - this stimulates the child’s interest in considering everything around him;
- control the load on the eyes when lying in the crib, ensuring uniformity;
- warning of contact with TV, tablets, smartphones before three years;
- limitation of the duration of stay in front of the screen
- prohibition to look at the screen while lying down;
- control of posture when writing, drawing - too low inclinations, regular maintenance of a specific inclination of the head significantly increase the risk of a pathological condition;
- a selection of children's books with capital letters;
- prevention of stress, strong negative experiences.
Prevention is especially significant if among close relatives there are those who have suffered strabismus or suffer from it. This fact indicates a predisposition to pathology.
Mindfulness - First and foremost
If the child has developed strabismus, you should not expect the doctor to offer a magical method to correct the situation in just five minutes. Whatever treatment option is chosen, the process will drag on for a long time, it will consist of several successive stages, and it will lead to success only with careful observance of medical recommendations. On average, doctors say, the fight against strabismus lasts up to three years, rarely when it is possible to fix the visual system faster than in a year. In many ways, the timing is determined by the timeliness of contacting a doctor, the adequacy of the chosen treatment program.
As soon as signs appear that make it possible to suspect strabismus, you need to immediately see a doctor. It is important to choose a qualified ophthalmologist who can immediately recognize if a child needs help. Only a competent therapeutic approach can guarantee a positive outcome of a comprehensive program.
Should I panic?
If the eyes of a child look in different directions, parents, noticing this, can be very scared. Do not worry too much: of course, this symptom requires an urgent appeal to the doctor, but does not mean that the cross is put on the future. If you manage to start the fight against the problem on time, the probability of a successful solution is close to one hundred percent. Modern ophthalmologists have access to effective devices and techniques, medicines, which means they can successfully cope with a variety of vision ills. Strabismus is no exception.