June 22, 2023 Author : Ricardo Dourado Leite This misalignment can occur: On the horizontal axis (converging or diverging); On the vertical axis; More complex clinical situation, in which several possible components coexist. Strabismus can be: Intermittent or constant; Acute or with a long course; Concomitant, when the deviation is the same in all gaze positions, or inconcomitant, for example, the deviation may be greater when the patient looks closer than far. Strabismus can be present at birth (congenital, which is not the most frequent) or develop later, from childhood to adulthood. The causes, clinical manifestations / symptoms, therapeutic approach, and prognosis are different in strabismus in children and adults. Strabismus in children Children's strabismus can be: Congenital , that is, being present at birth; Acquired , which is the most common and is often associated with refractive error. Congenital strabismus is more frequent when the child has neurological or syndromic diseases or was born prematurely. Strabismus can lead to a decrease in the visual acuity of the more permanently deviating eye (sometimes there is alternation of the deviating eye and this is a positive aspect), which is called strabismic amblyopia. In pediatric strabismus , we must almost always prevent or treat amblyopia and then operate on the strabismus. There are types of strabismus that are related to the existence of a graduation that is not corrected with glasses (refractive strabismus) and that disappear with the use of hyperopia correction. In these cases, surgery is not indicated. Strabismus in adults When approaching strabismus in adulthood, it is necessary to distinguish: Cases that have evolved for a long time (frequently since childhood), in which the surgical treatment has an aesthetic objective; Strabismus that appears only in this age group, which is normally associated with systemic problems, such as cardiovascular risk factors, tumors or trauma. The aim of treatment is to minimize the consequences of strabismus, which in these contexts leads to double vision. To eliminate this disturbing symptom, prismatic lenses can be used when the deviation is small, or it is necessary to resort to surgery in the most serious cases. Strabismus surgery Strabismus surgery is an extraocular surgery: The object of the intervention are the muscles that rotate the eyeball in different gaze positions; The muscles to be intervened vary according to the type of strabismus presented and in the preoperative consultation planning is performed. Strabismus surgery is performed under general anesthesia, on an outpatient basis, that is, there is no need for hospitalization. The postoperative period requires one to two weeks of activity limitation and topical application of eye drops and ointments, but there is no need to keep the operated eye covered. The effectiveness of surgical treatment of strabismus is very high . In almost all cases, the problem is resolved with a single intervention. Meet the ophthalmology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
