What are the causes and treatment of strabismus in children?

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

Visual impairment, in which, when looking straight, there is a deviation in the position of the eyes. Up to 2-3 weeks, the newborn is not yet able to fix his gaze due to insufficient development of the nervous system, but as he grows up, the visual system is formed.

From 5 weeks, a normally developing baby develops binocular vision, but strabismus periodically appears up to six months. When should strabismus occur in newborns? It is believed that by 6 months a child is already able to perceive objects in three dimensions, but the visual apparatus is fully formed only by 10-12 years.

If divergent strabismus is observed in children from 1 to 3 years of age, then treatment should be started immediately after the diagnosis is made.

Causes of strabismus in children

Treatment of strabismus in children begins after finding out the reasons for its appearance.

Its occurrence is influenced by:

• genetic factors;
• severe pregnancy;
• premature birth;
• diseases of muscles, nervous system, brain;
• anomalies of formation and development;
• violation of refraction;
• tumors in the organs of vision;
• traumatic lesions;
• infectious diseases.

If the causes of strabismus in children under one year old are hereditary diseases or intrauterine pathologies, the formation of the visual apparatus should be given special attention, and such children should be attributed to the risk group.

Often, parents deal with this problem only because they are worried about the appearance of their child. However, not only the appearance suffers, visual acuity and the ability to perceive objects in volume deteriorate.

pathology of strabismus in children

For the first time, an ophthalmologist examines a child's eyes when he is 3 months old. During the examination, the shape of the palpebral fissure, its width are assessed, the size of the eyeballs, the possibility of movement are measured. When examining the organ of vision, the state of the pupils and lens, the presence or absence of changes in the fundus and vitreous body are examined.

Examinations are carried out using an ophthalmoscope - the baby reacts to a luminous point.

At 6 months, it is already possible to identify the type of strabismus:

• friendly;
• paralytic;
• divergent;
• converging;
• vertical.

The child's eyes follow the movement of a bright toy, which is pushed towards them or pushed back. With the help of such an examination, refraction and angle of vision deviation are determined.

Finally, eye disease is diagnosed by 3 years. But by this age, it may already have an acquired character. The condition is provoked by myopia, astigmatism, diseases of the nervous and endocrine systems, traumatic effects and the consequences of infectious diseases.

In children aged 3 years, it is already possible to carry out a test with a cover. This makes it possible to reveal even hidden strabismus, in which one of the organs of vision deviates, if the second is excluded from the visual process, covering it with a hand.

To check the refraction of the eyes, it is necessary to prepare the baby in advance - atropine begins to drip in 5 days.

Visual acuity is checked using a special table, and binocular function - using a color test.

Treatment of strabismus in children

The earlier treatment begins, the more chances you have to correct the condition. Even if therapeutic measures are used at the first symptoms of the disease, it does not go away immediately. It takes at least 2-3 years to correct strabismus, and you will have to live according to medical recommendations.

Concomitant strabismus is treated in stages:

• At first, treatment is aimed at developing refraction skills - for this, special glasses with plastic glasses are put on for babies from 6 months. Glasses have to be worn all the time;
• After 3 weeks of constant wearing of glasses, pleoptic treatment is started - they try to equalize the visual acuity of both eyes - to correct amblyopia.

For this, both medications and computer methods are used - for example, the light of the retina of the eye, which sees better. The choice of the method depends on the age of the child and the clinical picture of the disease;

• Direct occlusion is used when the baby is 4 years old - not earlier. One eyepiece of the glasses - in front of the eye that sees better - is closed. They begin to close their eyes from 20 minutes, gradually increasing the development time of the diseased organ of vision. Every 2 weeks, the child is taken to an ophthalmologist to adjust the treatment and the time of the occlusion. There are enough exercises that help solve the problem of how to correct strabismus. With a vision of 0, 2 diopters, classes with an amblyotrener and a maculotester are effective - special ophthalmological devices;
• After the visual acuity in both eyes is leveled and refraction appears, orthoptic treatment begins. Its purpose is the formation of binocular vision. For this, another device is used - a synoptophore;
• Then comes the turn of diploptics - with the help of this method they give an impetus to the development of independent binocular vision, as well as with the child they perform exercises that contribute to the development of the eye muscles. At this stage, a special apparatus, a convergent trainer, can be used.

If the treatment turned out to be ineffective, the strabismus is congenital or its angle is too large, then you have to resort to surgical intervention. In some cases, it is advisable to carry out operations in several stages, assessing positive changes and adjusting the methods of influence.

Prognosis for the cure of strabismus in children

The earlier treatment is started, the more chances are to correct vision and eliminate a cosmetic defect. In a preschool child, the developmental anomaly can be eliminated almost completely and in the future he may not even need vision correction with glasses or lenses.

The easiest way to overcome a friendly accommodative strabismus - when the eyes squint simultaneously or alternately, deviating at a constant angle.

If paralytic strabismus - a condition in which the muscles responsible for the movement of the eyeballs are partially paralyzed - is detected in a school-age child, then it cannot be completely eliminated. Strabismus is accompanied by a violation of visual function, which will aggravate as we grow older.

The doctor can give an accurate prognosis for the disease only a year after the start of therapeutic measures.

Prevention of strabismus in children

If there are cases of the disease in the family, then it is necessary to visit an ophthalmologist with him every 2-3 months during the first year of the baby's life. In this case, treatment can be started when the first symptoms appear.

Do not hang objects that attract the baby's attention on either side of the bed. Rattles should be placed no lower than the child's arm's length.

You can not frighten the child, make sudden movements in front of his face. At an older age, children should be protected from psychological and physical traumatic influences.

Care should be taken to ensure that both eyes are evenly loaded with a baby lying in a stroller or crib. To do this, turn it over in the crib - with your head first in one direction and then in the other direction; provide free access to the wheelchair and bend over to it from different sides.

The age from which you can watch TV or play on the computer is determined by 3 years. You can only watch what is happening on the screen in an upright position - sitting or standing.

When the child reaches school age, it is necessary to monitor the illumination of the room during classes, choose books with large print, and set images on the computer screen so that you do not have to strain.

If the child already has vision problems, visual fatigue should not be allowed. Exercise for the eyes needs to be added to daily sports or exercise.

It is necessary to conduct an explanatory conversation with the children surrounding the baby in the kindergarten, school or yard. Otherwise, children may laugh at the fact that the child is wearing special eyepieces.

In this case, he will take off his glasses outside the home, and the effectiveness of the treatment will be much reduced. During conservative therapy, the baby should be provided with maximum psychological comfort.