Strabismus - its causes, types and treatment methods in Turkey

Strabismus - its causes, types and treatment methods

Amblyopia is the loss of parallelism between the eyes and asymmetry in the movement of the eyes when looking at a certain point. Amblyopia is one of the most common eye diseases and statistics indicate that 4% of people develop amblyopia.

The squint may be permanent or temporary.

Learn about the causes of around the eyes in adults and children, the types and accompanying vision disorders, and the latest methods of treating amblyopia in Turkey, under the supervision of a cadre of the best eye surgeons and their accessories.

Ophthalmology in Turkey has developed significantly in recent years, and it has become one of the leading countries in the field of ophthalmology.

Amblyopia is the failure of the eyes to maintain proper alignment and work together as a team. Amblyopia may always affect the same eye or may alternate between the two eyes (alternating strabismus). To prevent double vision in cases of congenital strabismus, the brain ignores signals from the deviated eye, causing Amblyopia. 

Definition of strabismus and its types

Strabismus is an optical defect that causes the eyes to move in a non-parallel and unbalanced manner, so the visual axes do not meet at a single point, which causes diplopia and double vision for the patient.

The eye has six muscles responsible for moving it in different directions. The muscles of the eyes work in the natural state in a symmetrical manner to maintain balance and symmetry of movements in both eyes, as the eyes look together towards the object to be seen, and the two axes of vision meet at one point. Dimensions This is a complex process conducted with careful coordination of the brain.

The eyes move in all directions thanks to six external muscles
Picture of the six oculomotor muscles

Strabismus is a common disease Estimates About 13 million people have amblyopia in the United States of America today.

It can be classified according to the direction of the deviated eye: strabismus shapes

  • Esotropia: the eyes deviate inwards, towards the nose.
  • Exotropia is the deviation of the eye outward towards the ear.
  • In the case of hypertropia, its deviation is upward.
  • In the case of hypotropia, the deviation of the eye is downward.
Strabismus is classified into four types according to the direction of the deviated eye
A picture showing the shapes of the strabismus

Types of crossed eyes

There are two basic types of squint around the eyes:

1. Comorbid strabismus:

In this case, the angle of squint (the extent of eye deviation) is constant in all directions of vision.

2. Incomitant strabismus:

The angle of strabismus differs according to the direction of sight, which may result from paralysis or weakness of the eye muscles.

Strabismus occurs in all age stages and often appears in childhood. The internal squint in the child appears in the first months of life, while the accommodative estropia affects the child at the age of two to three years and is caused by farsightedness.

The squint that appears with age is called acquired squint and is the result of weakness in one or both eyes, or paralysis of one of the ocular muscles for some reason.

3. Occult amblyopia (segments):

The squint does not appear except in cases of stress or when covering the other eye during the medical examination, then the hidden strabismus turns into an apparent strabismus due to fatigue as in the evening time and disappears in the morning upon awakening.

This type leads to clouding of letters and words, blurred vision and severe headache after working for two hours.

4. Pseudo-strabismus:

Some babies are born with a wide bridge of the nose and a fold of skin above the inner corner of the eye, giving the appearance of strabismus.
This condition may recede at the age of six months.

What are the causes of amblyopia?

The causes of injury vary from case to case, and in certain cases the cause remains unknown. Here are the most important causes of squint:

  1. Low vision in one eye (moderate to severe hyperopia, refractive power difference in one eye compared to the other eye, or due to less common problems such asto cushion congenital).
  2. Inflammatory conditions such as meningitis and diabetic neuritis
  3. Cerebral vascular lesions such as cerebral aneurysms.
  4. Down's syndrome
  5. Hydrocephalus is a structural defect that results in the accumulation of fluid in the brain.
  6. brain tumors;
  7. brain attack.
  8. Injury to the nerves responsible for moving the eye muscles (congenital or acquired).

What are the symptoms of amblyopia?

Strabismus has many different symptoms:

  1. Visual fatigue: redness and burning in the eyes, headache
  2. Difficulty reading and a decline in the child's academic level
  3. diplopia (double vision)
  4. Determined by eye movements
  5. Sometimes strabismus may be associated with ptosis of the upper eyelid.
In a normal machine, the eyes focus on the same point, but in strabismus, the eyes focus on two different points
An image to illustrate the mechanism of the occurrence of double vision in the squint

Strabismus diagnosis

Diagnosis of strabismus in children depends during the routine visit to the doctor, where an eye examination is conducted at each visit to the pediatrician, but in the event of a complaint of symptoms of strabismus or visual impairment or any other eye disorders at any age, a full eye examination must be performed by the ophthalmologist.

What is a squint test?

Strabismus test or what is called the corneal light reflex. The doctor directs the light perpendicularly towards the patient's pupil. In the case of strabismus, the doctor notes that the corneal light reflex is shifted from the center of the pupil in the eye affected by the squint.
This test diagnoses strabismus.

What are the complications of strabismus?

Strabismus results in many visual, formal and sometimes psychological complications:

riskfor visual complicationsAs the squint can lead to a disturbance of vision such as diplopia, one of the basic complications resulting from the squint is the emergence of amblyopia That is, eye laziness that results from the brain's neglect of images coming from one eye.

In most cases, strabismus causes an aesthetic disorder in the appearance of the face, and sometimes it may lead to psychological disorders in the sufferer.

Methods of treating amblyopia?

Treatment methods for strabismus vary according to the causative factor, and treatment can include: Using eyeglasses or contact lenses To fix an extension to see if it was the cause, treatment amblyopia Which may be a cause and a consequence of strabismusCovering the healthy eye with a patch To stimulate the affected eye. Sometimes, a procedure may be required Surgery To the injured eye muscles in order to correct their balance.

Strabismus surgery

The basic principle of strabismus correction operations is:

  1. Delaying the attachment of the strong muscle to the eyeball, i.e. returning it back, in order to weaken the muscle's ability to stretch.
  2. Shortening the weak muscle (i.e. muscle contraction) in order to strengthen it.
    This is done in amounts that vary according to the angle of strabismus determined by the doctor.

General anesthesia is used for most children, while it is performed for adults under local anesthesia, and the type of anesthesia depends on the patient and the presence of health diseases in addition to his preferences.

The lateral rectus muscle was shortened to correct strabismus
A picture showing the position of the eye after strabismus surgery

After surgery, it is normal for the white sclera of the eye to turn red after surgery.
It can take several weeks or sometimes months for the redness to go away.
The eyes are usually blurred and painful when moving.
The pain usually improves after a few days depending on the exact surgery that was performed.

The final result appears four to six weeks after the strabismus operation. Children under the age of 10 may need to repeat the operation to maintain the best results. In some cases, prismatic glasses may help adjust the movement of the eyes together.

There is a modern treatment method based on Botox injections. This method is effective in simple cases of strabismus.

Some may resort to using prisms and visual correction exercises as a complementary treatment to surgery in certain cases, such as intermittent lateral strabismus. As for prisms and prism glasses, they are used in the presence of diplopia.

Exercise therapy for strabismus

This method is used to treat lateral strabismus during near vision. A simple exercise can be done as follows:
Holds a pen in the hand and slowly brings it closer to the nose while fixing the gaze on it until diplopia occurs, then repeats this exercise several times a day for a period of weeks until the distance at which he suffers from diplopia is reduced.

Unfortunately, muscle exercises are only temporary and must be repeated from time to time to ensure the absence of symptoms continues.

Can it be prevented?

Strabismus cannot be prevented, but early diagnosis protects the child from complications.

Bimaristan Medical Center remains your first choice for treatment in Turkey.

We direct you to the best and most famous specialists in all fields. Do not hesitate to contact us. Bimaristan Medical Center is your family in Turkey. You can also read about it on our website The latest ophthalmology technology in Turkey.

Frequently Asked Questions

Treatment may include wearing glasses, patching, eye exercises, medications or surgery.

The success rate of strabismus surgery in Turkey is about 80%, according to the latest studies.

Most of the time, the results of the strabismus operation appear within several weeks of the operation.

In general, there is no harm to the strabismus process other than the possibility of bacterial infection.

If you are planning for treatment in Turkey
you can talk to us here.

If you are planning for treatment in Turkey
you can talk to us here.