Squinting (strabismus)

Squinting (strabismus)

Squint: Causes, Symptoms and Surgery of strabismus in children and adults

If one speaks colloquially of crossed eyes, then is medically correct of strabismus the speech. Squint is a misalignment of the eyes caused by a disturbance of the balance in the eye muscle. Strabismus can be pronounced differently, whereby possible restrictions in the everyday life and the Need for surgery as a therapy vary. Squinting can occur both generally and constantly and be clearly visible to other people, as well as occur only in certain situations suddenly. For example, if a certain angle is taken.

Not every form of strabismus is in need of treatment, since strabismus is not always due to illness. Many sufferers, especially parents of squinting children, however, wish for cosmetic reasons or for mental relief therapy. However, pronounced strabismus is a serious eye disease that can lead to life restrictions.

Mostly strabismus genetically inherited and can be diagnosed and treated at an early age. In addition, strabismus can also be advanced in adults suddenly occur, for example after a stroke. Whether a strabismus can be completely cured depends on the severity of the disease and the age of the patient. There are now many modern therapies and surgical methods available that allow safe treatment of children and adults.

Important: The treatment of squint is one of the specialties of ophthalmology and should be done accordingly by a specialist with a lot of experience. In ophthalmic surgery, the costs should not be in the foreground, if the cosmetic correction by health insurance is not taken.

Causes of strabismus – identification often difficult

In medicine, various forms of strabismus are known. Accordingly, different causes are known depending on the severity. Basically, the various forms of strabismus are caused by changes in the optic nerves and parts of the eye area. What exactly causes these changes can often not be answered exactly in the individual case. However, since strabismus as a clinical picture is well researched and numerous surgical methods are available, intensive causal research is not absolutely necessary.

Different forms of strabismus in detail

In practice, many forms of strabismus are known. These include:

  • Latent squinting (heterophoria): Latent strabismus is a disturbance of the equilibrium in the eye muscle, which can often be compensated by those affected and thus remains without symptoms. Often the disease is not recognized, because only from a certain disease intensity, complaints occur. Latent strabismus can be innate, but can also be caused by external influences. In particular, long hours in front of screens can promote the emergence.
  • Manifest squinting (heterotropy)If a permanent deviation of an eye from the normal line of sight is to be determined, then it is a matter of heterotropy. It is further distinguished between inner squint, outer squint, squint and Verrollungsschielen. A combination of these characteristics is possible. Unlike the latent squint, the manifest squint is also expressed by the visibility, which is perceived by many sufferers as unpleasant. Depending on the severity of the disease, different treatment options may be considered, which aim at preserving vision and reducing visibility.
  • paralytic strabismus: Typical for the paralysis squint is that the affected eye is basically limited in its ability to move and squint does not occur only at certain points. The severity depends on the underlying nerve damage and ranges from mild deficits to complete paralysis.
  • Mechanically caused strabismus: Another common type of strabismus in children and later in adulthood is mechanical. For example, certain diseases can lead to strabismus. Also benign changes of muscle and connective tissue mass are mentioned here.
  • Pseudostrabismus: Also known is a strabismus, which is superficially visible, but not a disease in the medical sense, as there are no restrictions associated with it. Frequently, patients or parents of affected children desire corrective surgery of the eyes for cosmetic reasons. A well-known personality who suffered from pseudostrobism was Anette von Droste-Hülshoff.

Schiel OP in children? When to the doctor?

Due to the numerous manifestations of strabismus, there are also numerous therapeutic options. Many therapies are on one long-term and complete correction of crossed eyes aligned and are therefore lengthy. If a therapy is started in early childhood, this is usually completed in adolescence and a strabismus medically and cosmetically completely cured. In order to be able to treat concomitants as successfully as possible, it is necessary to start therapy in children at an early age. So if parents notice malpractices or abnormalities in their children, the prompt visit of an ophthalmologist is recommended.

The most common observations and reasons for a doctor’s visit include:

  • Child switched on with one eye inside
  • Child squints outward with one eye
  • Child squinted with both eyes
  • Child turns on tiredness
  • Child turns on concentration or in certain situations

Many parents ask themselves: When to the ophthalmologist? If your baby or child switched, the answer is simple: Immediately! Especially with babies (about 9 months) and infants from 2 years to 4 years old, squinting can be a warning sign for low-vision or ametropia. This should never be labeled as harmless and in any case by a doctor with experience in eye diseases in infants examined.

With a slight squint (Silberblick) is often the Correction by means of glasses advised. This makes it possible at the same time to compensate for side effects, such as a defective vision. Another typical form of therapy is the occlusion therapy. The affected eye is stimulated either by a patch, a blindfold or by a special film on a visual aid to fix. How often an occlusion therapy is necessary, the ophthalmologist depending on the circumstances.

In addition, there are many more drug or surgical treatments. For example, the healthy eye can be crippling eye drop obstruct, causing the affected eye to correct. In particularly severe cases, an OP, popularly known as a squint surgery comes in question. Often it is necessary in the context of an operation to operate even the healthy eye. The cost of a squint surgery for medical reasons should be discussed and approved with the health insurance company prior to surgery.

For less severe manifestations, further therapeutic approaches with different chances of success are available. Only one patient familiar with the patient can provide information about the chances of success. Typical procedures are about Orthoptik or Pleoptics, which provide relief in certain cases. The costs usually have to be taken over privately, since the health insurance only actually pays for medically necessary forms of treatment.

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Christina Cherry
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