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Strabismus causes symptoms diagnosis treatment

Strabismus is one of those vices that will not hide under a pile of clothes, will not encode Chinese literacy in the patient card. He never accompanies man, giving him insulting nicknames and providing an inferiority complex for many years to come. Meanwhile, strabismus does not constitute an insoluble problem for modern medicine. In addition, pathology of the eye muscles (which is what underlies strabismus), causing a non-parallel position of the eyes is quite possible to fix.

For a start let's understand, what is fraught with strabismus, what consequences it carries for the health of the individual. In the normal, state both of our sight focused on one point. Each of them transmits to the brain the image with his "bell tower". The brain combines these two images, processes them, and presents holistic volumetric visualization. Moreover, the fact that the eyes see the object differently, it is easy to verify in practice. Probably not a man who is not amused as a child watching at arm's length is one, then the second eye, closing the adjacent eye. In addition, in each case, the hand several changed its position. This also caused the necessity of preliminary processing by the brain-received information, to interpret it as one.

Six pairs of extraocular muscles provide eye movement. For their coordinated activity of the brain is responsible. To get both eyes looking in one direction, it is extremely important to coordinate the work of the oculomotor muscles.

Especial strabismus is for children. The fact that the child's body has a very high adaptability. In case of strabismus, the brain receives two images, which he is unable to associate in a single unit. The question arose of the double vision, the brain decides to radically: suppresses one image to another. For a very short time the sight of defective eyes is suppressed permanently, he becomes amblyopic (there are still such doctors used a figurative expression — "lazy eye"). Continue to adjust the sight will no longer be possible or the glasses or lenses will not help. Therefore, children strabismus must be identified as early as possible. Another apparent defect going hand in hand with pediatric strabismus compensatory rotation or tilt of the head to help in some way to get rid of the ghosting.

If the strabismus is acquired in adulthood, ghosting is not to get rid of, because the adult brain is much more limited in terms of adaptation.

Causes of strabismus

The causes of strabismus are divided into several groups:

  • ophthalmic. This may be genetically determined hypoplasia of the muscles of the eye, mechanical trauma and eye tumor, refractory anomalies, including anisometropia (when the eyes have different refraction) and amblyopia (impaired vision associated with brain lesions)
  • neurogenic, including paresis (partial weakening of muscle strength), paralysis and multiple sclerosis
  • hormonal (hyperthyroidism up to the state of toxicosis)
  • infectious (influenza, mumps, measles)
  • mental (neurotic disorders, severe fright)

Strabismus may be present from birth or acquired with age.

Symptoms of strabismus

Strabismus is one of those diseases, the symptoms of which what is called to mind:

  • deviation of eyes from an imaginary straight line, striking the focus. The eye can "pull" toward the nose or temple
  • turn or tilt of the head, and not fleeting, but enduring is a warning
  • squinting
  • the decrease in visual acuity
  • increased eye fatigue (asthenopia)

It is necessary to distinguish a true squint from apparent squint encountered in children under the age of 6 months. The kids still cannot fix the eyesight on the objects, so the parents created an imaginary feeling that the eyes of a child if "float" that should cause parental concern. Another "snag" — the individual features of the structure of the skull, when a broad nose also can provoke others into thoughts of strabismus. In these cases, nothing abnormal is the norm.

Diagnosis of strabismus

To make an accurate diagnosis, help the ophthalmologist comes in a range of methods, techniques and studies:

  • determination of visual acuity with correction and without it
  • the study boundaries (fields) peripheral view, narrow known in medical circles as perimetry
  • the simplest method of tracking the amount of movement of the eyes. Show the patient a pen or a finger, which the doctor moves in different directions. The patient needs to closely monitor these movements on the basis of what the doctor will issue a preliminary verdict on the state of the oculomotor muscles (paralysis of the eyes may not move at all)
  • definition of refraction in the pupil is enlarged with a Refractometer or shadow tests;
  • it is used to determine the nature of vision, which can be binocular (involving both eyes) monocular (one eye) and simultaneous (two eyes, but without the merging of visual images). The patient put on special glasses and show a screen with the multicolored circles. After counting visible patient circles and define their color and the doctor establishes the nature of vision
  • on a special device — synoptophore — determine the presence and angle of strabismus
  • examination of the eye fundus
  • ultrasound of the eye
  • strabismus treatment

The first step is to eliminate all the possible causes of strabismus, of course, if any. The next task of the ophthalmologist is to achieve Central fixation, to correct strabismus, or at least make it to be intermittent. In the latter case, amblyopia develops much slower.

Then is the selection of adequate corrective devices (glasses, lenses). If the strabismus is accommodative in nature (strong myopia or hyperopia in one eye), a defect can be neutralized at this stage.

Further to the foreground the techniques from the Arsenal preoptic, the main task of which is the exclusion of the visual process healthy eyes by setting it opaque screen (this technique is also called "gluing"). Time of this procedure is selected individually. Fortunately, you can sleep without the screen.

If the squint angle exceeds 15 degrees, it is necessary surgical treatment be resorted to in the absence of effect of long — 1-2 years of wearing corrective devices. The best result from operations can be achieved at the age of 4-5 years. At large angles of strabismus possible two-stage surgical interventions with a time interval between them not less than six months. Operations can have two directions: increase effect of muscle (cutting the muscles, the level of fat in the folds move the attachment of the muscle forward) or weakening (lengthening the muscle incisions, the muscle-tendon plastic, moving the attachment of the muscles of the back).

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