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What is strabismus?

Strabismus is misalignment of the eyes. About 4% of the U.S. population has misaligned eyes. That’s 1 in 25, making it a prevalent visual problem.

Are there different types of strabismus?

Eye misalignment can be horizontal or vertical. Esotropia and exotropia are the horizontal types of strabismus; inward turn and outward turn from the Greek. Some people call the condition crossed eyes. Vertical strabismus is less common.

Do children inherit this condition?

Strabismus is congenital as well as acquired. The condition affects infants, children, adolescents and adults.

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What are the signs and symptoms of strabismus?

The most prominent sign is a deviation of one eye relative to the other eye. Misalignment causes eye strain, reading and driving difficulty as well as diminished hand eye coordination.

What causes Strabismus?

The eye has six muscles that position each eye on objects of visual interest and follows them if they move. The brain coordinates the movement of these muscles to maintain object and dimensional clarity.

Most strabismus is the result of an abnormality of the poorly understood neuro-muscular control of eye movement. The brain may not be sending correct messages to eye muscles or the neural pathway between the two may be malfunctioning. Children with cerebral palsy, Down syndrome and brain tumors are likely to have strabismus. Abnormal facial and orbital bone shapes can cause misalignment. The eye muscles may be impaired or the nerves that control the eye muscles may be paralyzed.

How is strabismus treated?

Treatments of strabismus include corrective glasses, prism and surgery. Each kind of strabismus requires a thorough evaluation by an ophthalmologist/eye surgeon to determine the appropriate therapy.

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What is strabismus surgery?

Strabismus or eye muscle surgery strengthens or weakens eye muscles which change the alignment of the eyes relative to each other. The eye muscle is reached through the conjunctiva. The ophthalmic surgeon tightens, shortens or repositions the eye muscles depending upon the eye deviation. No skin incisions are made. The eyeball is never removed from the eye socket during strabismus surgery.

What type of anesthesia is used for strabismus surgery?

Anesthesia type is dependent upon the age, health and preference of the patient. Most children receive general anesthesia. Adults may have general or local anesthesia.

How successful is eye muscle surgery?

Most patients experience significant improvement of eye alignment with one surgery. Occasionally, the surgery is only partially successful and a second surgery is required.

When should strabismus surgery be done on a child?

The goal of strabismus treatment is to improve eye alignment. This optimizes the development of binocular vision. When corrective glasses or prisms are inadequate, surgery is recommended. Surgical correction of esotropia (inward) can be performed on infants at 6 months. Exotropia (outward) and other eye alignment deviations can be corrected on an elective basis.

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What age is “too old” to have eye muscle surgery?

Eyes can be straightened at any age. Strabismus surgery should be considered if it will enhance the patient’s quality of life.

Is strabismus surgery cosmetic surgery?

No. Eye muscle surgery improves eye function in children and adults. Studies have shown that misaligned eyes can hinder social development, self confidence and employment opportunities. Everybody deserves straight eyes if possible.

What can a patient expect from strabismus surgery?

The procedure is performed in a surgery center or hospital operating room. Patients are usually allowed to go home that day. Mild discomfort and foreign body sensations commonly occur. These are temporary conditions that can be controlled with over the counter pain medication. Most patients resume normal activities in a few days. Swimming, contact sports and any activities that could result in eye trauma are prohibited until the patient completely recovers.

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