Squint or strabismus (strabismus) - a pathology of view. When strabismus eyes are not installed and deflected away from the normal angle of view, not focusing on one point.
What's wrong with strabismus
We are looking at two eyes in the same direction, but in the brain receives some excellent images of the left and right eyes. In the visual cortex of the brain superimposes the image one by one and creates a real, single image, which is three-dimensional volume, and - this is the normal binocular vision.
When strabismus focus of each eye falls on different terms, and the images are too different. In this case, the brain can not combine them into a single image, and it turns out the unbalance of view.
To avoid confusion, the brain begins to turn off the image from the affected eye, gradually turning it from a process view. In ailing eyes there is a progressive decrease in vision - amblyopia.
When strabismus amblyopia develops quickly enough, but with the right treatment can fully restore vision. If not a very high degree of strabismus images may overlap, but the picture may be split in two.
Causes
Strabismus can be
- birth due to genetic predisposition, pathological course of pregnancy, birth defects or congenital abnormalities of the eye muscles,
- acquired as a result of injury, disease, infections, eye pathologies, etc.
Also causes strabismus can serve
- injury or eye tumors, malformations of the eye muscles, abnormal vision,
- paresis or paralysis of the eye muscles,
- thyroid problems,
- measles or flu-like lesion,
- fright, neuroses.
Stand friendly squint, when the normal axis deflected both eyes, and monolateral - when basically suffers one eye.
types
secrete
- The apparent strabismus, it occurs in children up to six months due to the floating eye movements. In addition, there is an apparent strabismus in children with a broad bridge of the nose.
- Latent strabismus, manifested due to the difference in the strength of the muscles from different angles. If the child is looking with two eyes, strabismus is not noticeable, but if a child is watching with one eye, closing the other, the second one can be refused.
- True. Constant strabismus, which is detected under any conditions.
Strabismus can be
- convergent (esotropia) when one or both eyes converge to the nose,
- divergent (exotropia) when one or both eyes to diverge temple,
- vertical when the eye is directed upwardly (Hypertropia) or downward (hydrotropes)
- mixed when they can combine several previous forms.
Depending on the characteristics of accommodation (with vision problems) can occur
- neakkomodatsionnoe strabismus, in which the correction is independent of the points, and helps only surgery,
- partial accommodative strabismus, it is partially compensated by glasses or lenses with correction,
- accommodative strabismus, with proper selection of points is eliminated.
The magnitude of deviations from the normal line of sight can be strabismus
- small, with a deviation of up to 5 °
- small, with a deviation of 6 to 10 °
- an average, a deviation from 11 ° to 20
- expressed with a tolerance of 21 to 35 °
- very pronounced, with a deviation above 36 °.
Manifestations of strabismus in children
The main sign of strabismus - a visually noticeable deviation of the eyes in the direction from the normal position.
In addition, in strabismus can be also forced position of the head, the child constantly tilts or turns to one side. This is necessary to compensate for a split image.
A child can squint, he has a headache or dizziness, decreased vision affected eye.
At the paralytic form of strabismus affected eye deflected to the side, partially or completely immobile, strongly disturbed vision in the affected eye.
Diagnostics
Strabismus problems involved children or adults ophthalmologists.
In addition to visual inspection and establishing the fact of strabismus, it is necessary to carry out some diagnostic methods:
- visual acuity with correction lens without it,
- determination of the amount of eye movement during tracking of objects (up and down movement, left-right)
- conducting perimetry (determination of visual fields)
- fundus examination with dilated, the definition of refraction (eye refractive power in diopters media)
- holding the four-tsvetotesta by which define one or both eyes of the patient sees (monocular or binocular vision it)
- in addition may be conducted eye ultrasound, CT scan to exclude organic causes strabismus (tumors, hematomas, defects).
Sometimes you need consultation of the neurologist and an endocrinologist.
treatment of strabismus
strabismus treatment should start as early as possible to prevent loss of vision (amblyopia) Squinting eye.
Correction of strabismus surgery without
First of all, held addressing the causes that provoked the squint. In addition, it is necessary to achieve the complete elimination of strabismus or make it even less pronounced.
If strabismus occurs because of poor eyesight, or is selected spectacle correction lens in accordance with the degree of reduction.
Spectacle correction is performed not earlier than 6-10 months, as before strabismus may be due to the peculiarities of view.
After that, use the methods zakleek - throughout the day close eye that sees better. At the same time squinting eye becomes the master, and the sharpness of his vision improves.
Used special devices to improve vision and eye fixation of the central position.
As you reach the desired visual acuity, eye develop the ability to merge pictures and friendly movements without deviations. Eyes give different parts of images to be joined, giving the correct setting eyes on a special device (binarimeter or sinoptoforah). Applied physiotherapy.
Surgical correction of strabismus
With a high degree eye deviations of more than 10 degrees, apply pre-surgical correction, then its complement methods described above.
The operation does not change the application of further methods of conservative therapy, and is just one of the stages of treatment.
Indications for surgery:
- progression of the process, despite the therapeutic measures,
- lack of effect of wearing glasses or lenses for a year or more,
- high angle strabismus.
If the angle is over 30 degrees, operate in two stages, as well as in the bilateral strabismus, operations prescribed intervals in half - one eye, then the second.
The operation consists in shortening or lengthening of the eye muscles, depending on the form of strabismus.
The prognosis for treatment
The prognosis for timely treatment is favorable, but in advanced stages may be irreversible loss of vision in one eye with inability to purchase in the future in certain occupations and imposing certain restrictions in the life (transport driving lessons sports).
