Eye Problems In Children: Strabismus And Ambylopia

One significant cause of concern for new parents is "crossed eyes" or "lazy eyes". A complaint of "eyes not looking right" is often a topic of conversation in well child visits. One of the eyes may appear to point in different directions than the other eye. These are actually quite common concerns and luckily the eye often corrects itself after a few months. Early recognition and treatment may often avoid permanent eye problems.

Strabismus ("Cross Eyes")

Strabismus or misalignment of eyes may have different reasons for its occurrence. Most believe it's an inherent weakness in one of the eye muscles and there does appear to be a genetic component to strabismus. Others argue that it's a problem with brain activity to the eye. What can occur with misaligned eyes is that the brain receives two different images when attempting to create a three-dimensional picture. When this occurs, a child may tend to ignore the poorer producing image and rely on the more dominant "better producing" image. This is known as ambylopia, which is a visual defect, affecting 3 out 100 American children. It's important to see a doctor if the eyes do not correct itself after a few months, as uncorrected ambylopia may lead to permanent blindness. About 4 percent of children develop this problem before age 6.

There are a variety of types of strabismus. Esotropia is when the eyes turn inward. It's the most common type. Exotropia is when the eyes turn outward. Hypertropia and hypotropia are when the eyes turn up and down, respectively. It should be noted that the deviation is not always constant. In some cases, surgery may be required. Ophthalmologists recognize that true strabismus does not correct itself over time.

Diagnosis of Strabismus

There are various tests a pediatrician or pediatric ophthalmologist performs to determine strabismus. Tests include checking for corneal reflexes as well as covering and uncovering the eyes to detect deviation.

Treatment of Strabismus

If the child does not adequately gain control of his or her eye muscles, surgery may be used to correct it. However, special eyeglasses or bifocals are tried to straighten the eyeballs on their own. Patching or eye exercises may be prescribed. Sometimes drops are used. Strabismus surgery involves manipulating and repositioning the eye muscles. Recently Botox injections into the muscles have been recently approved by the Federal Drug Administration to be used in the treatment of strabismus.

Ambylopia ("Lazy Eye")

Ambylopia, as mentioned, occurs when poor vision develops in one eye during childhood. It's also known as "lazy eye". Strabismus is the most common cause, but can occur if a child develops cataracts or refractory errors.

Diagnosis of Ambylopia

It can be very difficult to diagnose ambylopia in children. The eye professional will test visual acuity individually and perform a series of tests involving following and locating objects.

Treatment of Ambylopia

The hallmark of treatment of ambylopia is forced use of the weaker eye, through covering or patching the dominant eye. If strabismus is the possible, appropriate treatment is utilized. Loss of depth perception and lifelong unilateral poor vision may result if not corrected.

Experts agree that early recognition of strabismus and ambylopia lead to more successful treatments of these diseases (Normal visual development may have already taken place). If you suspect your child has an eye problem, do not hesitate to see your optometrist or eye specialist.

In the Spotlight