Ophthalmic diseases: how to treat strabismus?

Strabismus is a rare disease. It is common among children 2 to 3 years old. Strabismus requires competent, comprehensive treatment. First the doctor can prescribe conservative therapy, then - the surgical. Treatment depends on the form and clinical symptoms of the pathology. Folk remedies in this case are not effective.

Definition of disease

Strabismus or strabismus is the permanent or periodic deviation of the visual axis of the eyeball from the fixation point.Through this pathology binocular vision is broken - the ability to reproduce a clear image with both eyes simultaneously.

This disease manifests itself as an external defect, when the pupil of one eye or both eyes is not centered.

Most often, strabismus is diagnosed in children(-3% of the occurrence) regardless of the sex of the child. The disease is manifested, as a rule, by the age of three, when the final formation of the visual apparatus is achieved.

In addition, congenital strabismus can also occur. Then the diagnosis is simplified and the pediatricians start immediate treatment.

Strabismus is not only a cosmetic defect. This pathology extends to all departments of the visual apparatus and is often accompanied by other visual disorders, among which the most popular amblyopia.

Amblyopia occurs due to constant double vision in the eyes.In order to get rid of this symptom, the CNS suppresses the signals that come from the mowing eye, which leads to a decrease in its function, and then completely excludes it. Without proper treatment, the development of amblyopia occurs in 50% of patients with strabismus.

Classification

Strabismus is classified according to such signs: the timing of the onset, the involvement of the eyes, the severity, the direction of the mowing eye, and because of the occurrence.

The terms are as follows:

1. Congenital or infantile- develops in the first 6 months after birth.
2. Acquired- develops up to 3 years.

Also considered on the basis of stability - periodic and permanent.

Eye involvement:

1. Monolateral or unilateral.
2. Alternating, when one or the other eye is mowing.

The severity of strabismus is divided into:

1. Hidden(heterophore).
2. Compensated, which is detected exclusively by the ophthalmologist at the examination.
3. Subcompensated- after diagnosis in the case of a decrease in eye control, this form manifests itself.
4. Decompensated- Uncontrollable strabismus with a pronounced cosmetic defect.

Classification in the direction of the eye:

1. Horizontal- the mowing eye "looks" at the bridge of the nose or towards the temple (converging and divergent)
2. Verticaldivide by the deviation upwards and downwards.
3. Mixedform (cyclotropy) - when the eye is deflected towards the temple and upwards, downwards and looks at the bridge of the nose and so on.

Friendly

With this form of pathology, the movement of the eyeballs is fully preserved, but binocular vision is absent.Also there is no diplopia (double vision). Ophthalmologists divide this form into accommodative, partially accommodative and non-accommodative.

• The accommodative species of friendly strabismus is determined by the frequency of occurrence at the age of up to 3 years, and with an average or high degree of myopia, hypermetropia or astigmatism. Corrects, as a rule, contact optics.
• Partially-accommodative and non-accommodating species are manifested up to two years of life, is not based on accommodation disorders and is treatable exclusively surgically.

Paralytic

With this form of strabismus, the main cause of deviation is paralysis or damage to the eye muscles, in which the mowing eye remains stationary.Damage to the oculomotor apparatus can be triggered by external factors (injuries, diseases), and internal (disruption of the body systems).

Causes

The most common causes are:

1. Congenital forms: heredity, genetic disorders - Cruson Syndrome, Down, malignant effects on the fetus of medicines, alcohol, drugs.
2. Purchased: ametropia - myopia, hypermetropia, astigmatism and others.

There are cases when the acquired form developed as a result of infectious pathology(measles, scarlet fever). Acquired strabismus may occur with cataracts, leukemia.

Possible causes of the cause of the disease: atrophy of the optic nerve, detachment of the retina. The paralytic form of the disease occurs in tumorous processes, against the background of paralysis of the brain nerves. For other reasons, strabismus is a stroke.

Symptoms

A characteristic sign of the disease is the atypical position of the iris and the pupil.When the strabismus is strabismus, the mobility of the optic organ is impaired:the eye is deflected towards the unhealthy muscle.

In addition to obvious cosmetic abnormalities, the following symptoms are also possible, which are diagnosed by an ophthalmologist:

1. Ptosis of the eyelid due to paralysis of the oculomotor nerve.
2. Presence of diplopia with friendly strabismus.
3. Amblyopia.

A patient with paralytic strabismus has a reflex, in which the head rotates in a certain direction. This reflex is aimed at compensating for impairment of visual functions. The image falls into the center of the retina: in the eyes it does not double.

Possible complications

Among the common complications with strabismus:

1. Glaucoma.
2. Cataract.
3. Atrophy of the optic nerve.
4. Neuritis.
5. Dystrophy and retinal detachment and others.

Complications of this pathology include most eye diseases that are not associated with infections, since when metabolism is disrupted metabolism inside the eyeball.

Treatment

Conservative way

These techniques are aimed at eliminating the asymmetric position of eyeballs.Contact lenses and specialized procedures allow you to restore visual functions.Depending on the type of disease, optical vision correction, pleoptics is prescribed.Optical correction helps restore visual acuity, normalize accommodation and convergence.

Mandatory appointments (alternative - lenses). If the patient has accommodative strabismus, conservative treatment gives good results. Hypertrophy is eliminated, binocular vision is normalized.

Wearing glasses or contact lenses is necessary for different forms of strabismus. Pleoptic therapy is prescribed with amblyopia. It increases the load on the affected eye.

For treatment, computer techniques, magnetic stimulation, photostimulation, specialized massage with vacuum are used.Therapeutic measures help to restore binocular vision in both eyes.Depending on the clinical picture, the doctor can prescribe procedures for which synaptic devices are used.

Surgically

The operation is necessary to correct the angle of strabismus.Surgical treatment is carried out in stages. The nature of the intervention depends on the type of illness.The goal of some operations is to weaken the functioning of the eye muscles, others help to strengthen the functioning of these muscles.Before and after the procedure, orthoptic therapy is prescribed, helping to eliminate residual deviation.Surgical treatment gives a good result, but there may be side effects, such as hypercorrection, incomplete correction.Infection is observed in isolated cases.

Surgical treatment is recommended when the conservative is ineffective. The operation is performed before the eyes if the conservative treatment does not yield results within a year.

Prevention

1. An examination with an ophthalmologist.
2. Timely diseases associated with the eyes.
3. Eye hygiene.
4. Dosed visual load.
5. Competent treatment of infectious diseases.
6. Attentive attitude to the fetus during pregnancy.

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conclusions

Strabismus requires complex treatment. If signs of the disease are identified in the child, you need to urgently take him to the doctor! Timely therapy allows you to avoid dangerous consequences, among which a rapid decrease in vision.

Read also about what a microphthalmus is and how the operation is performed on the eyes.