Strabismus (Mata Juling) | Dr. Paramastri Arintawati, SpM

Summary

Strabismus, or crossed eyes, is a condition where the eyes are misaligned and point in different directions. It can affect one or both eyes and can be constant or intermittent. Causes include muscle imbalance, congenital factors, refractive issues, or neurological problems. Treatment depends on the underlying cause, ranging from glasses to surgery. Early detection is vital, especially in children, as untreated strabismus can lead to amblyopia (lazy eye) or other serious conditions. Surgical correction involves strengthening or weakening eye muscles for better alignment, with recovery taking 6-8 weeks.

Takeaways

• 👀 Strabismus, or crossed eyes, is a condition where the eyes are misaligned and look in different directions.
• 🔍 There are various types of strabismus, such as exotropia (outward), esotropia (inward), hypertropia (upward), and hypotropia (downward).
• 👶 Strabismus can affect one or both eyes and may occur at any age, from infancy to adulthood.
• ⚠️ Strabismus can be constant or intermittent, appearing only under certain conditions.
• 🔄 The main cause is an imbalance in the eye muscle movements, leading to misalignment.
• 👓 Strabismus can also result from refractive errors, congenital conditions, neurological issues, thyroid disease, or trauma.
• 🧬 The condition may have a genetic component and can be inherited.
• 🩺 Diagnostic tests for strabismus include vision acuity tests, refraction tests, cover tests, and three-dimensional examinations using a synoptophore.
• ⚙️ Treatment varies: if caused by refractive errors, glasses are prescribed. In other cases, addressing the primary condition (e.g., cataracts, thyroid disease) is prioritized.
• 🔪 In severe or congenital cases, surgery may be needed to correct muscle imbalances and restore eye alignment.

Q & A

What is strabismus, commonly known as crossed eyes?

Strabismus, or crossed eyes, is a condition where the eyes are not aligned properly, causing them to look in different directions. It can involve one or both eyes and may be constant or appear only in specific situations.

What are the different types of strabismus?

The types of strabismus include exotropia (eyes turning outward), esotropia (eyes turning inward), hypertropia (eyes turning upward), and hypotropia (eyes turning downward).

What are some common causes of strabismus?

Strabismus is caused by an imbalance in the muscles that control eye movement. It can also be caused by congenital issues, refractive errors, lazy eye (amblyopia), cataracts, nerve disorders, or trauma. In adults, it may also result from thyroid disease or nerve damage.

How does strabismus affect different age groups?

Strabismus can occur at any age, from infancy to adulthood. In children, it is often due to congenital factors or refractive errors, while in adults, it is more likely to be caused by nerve issues, thyroid problems, or trauma.

What are the common symptoms of strabismus?

Symptoms include misaligned eyes, double vision (diplopia), difficulty focusing, and in some cases, lazy eye (amblyopia). In severe cases, it can also cause difficulty with depth perception and coordination.

How is strabismus diagnosed?

Diagnosis involves several tests such as visual acuity (to assess sharpness of vision), refractive error tests (to check if corrective lenses are needed), and tests for eye movement like the cover test and prism test to measure the angle of deviation.

What are the treatment options for strabismus?

Treatment depends on the cause. It may include corrective lenses for refractive errors, eye exercises, or surgery to realign the muscles. If caused by another condition like cataracts or thyroid disease, treating the primary issue is crucial before addressing the strabismus.

When is surgery required for strabismus?

Surgery is typically recommended when other treatments like glasses or exercises are insufficient, or in congenital cases like esotropia in infants, where surgery is needed before the age of two to improve eye alignment and vision.

What is involved in strabismus surgery?

Strabismus surgery involves adjusting the muscles controlling the eyes—weakening the stronger muscle or strengthening the weaker one to realign the eyes. The procedure is performed under general anesthesia, and recovery typically takes 6-8 weeks.

Why is early detection of strabismus important?

Early detection is crucial because untreated strabismus can lead to complications like lazy eye (amblyopia) or even permanent vision loss in severe cases. Detecting it early, especially in children, allows for more effective treatment and better outcomes.