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3. Correcting Ocular Misalignment (Strabismus)

Volume 3 2000

Correcting Ocular Misalignment (Strabismus)

Michele L. McLeod, M.D.


Strabismus (wandering or crossed eyes) occurs frequently in early infancy. This early tendency occurs because development of vision and binocularity (using both eyes together) is an ongoing process during the first six months of infancy. Parents typically notice that their baby’s eyes seem to cross or wander during the first few months of life. 

Some children are at increased risk of developing strabismus, particularly those who are born significantly premature. Those with a family history (including siblings) of strabismus or amblyopia (poor vision in one or both eyes uncorrected or only partially corrected by glasses), are also at a higher risk. Extreme farsightedness or nearsightedness can also lead to the development of strabismus.

Most babies with very early strabismus correct their alignment by the end of the visual development period. There-fore, a pediatrician will not refer an otherwise healthy baby with strabismus to an ophthalmologist, unless the condition continues beyond six months.

If strabismus persists, it indicates that the developmental process has gone awry. Therapy or treatment should begin immediately to prevent the development of amblyopia, because children with strabismus tend to suppress vision in one eye, thereby avoiding double vision. Amblyopia is correctable with treatment only up to the age of seven or eight years, and best results in therapy are often achieved in younger children.

Strabismus responds extremely well to treatment, and the treatment chosen depends on the type of strabismus and other factors individual to each patient. Some patients, particularly those whose eye wanders away from the nose, may learn to control this tendency themselves, with careful follow-up by an ophthalmologist. In others, corrective glasses may correct the strabismus, along with treatment and close moni-toring of visual problems.

For certain children, glasses do not sufficiently align the eyes, or are not needed. These children usually require surgery to straighten the eyes. Eye muscle surgery is typically performed on an out-patient basis in a hospital or ambulatory center under general anesthesia. Patients may experience minor discomfort for the following few days; this can be relieved with pediatric pain relievers. In most cases, full recovery occurs in less than one week, and post-surgical results are excellent. 

Strabismus may also develop in adults as a result of trauma or systemic disease, such as strokes or thyroid disorders. Adults who had strabismus as a child may also re-develop the condition. In adult cases, it is important to screen for and treat any underlying cause of strabismus, in conjunction with strabismus therapy.

Dr. Michele McLeod specializes in the treatment of strabismus in children and adults. She sees patients in MKMG’s Mount Kisco and Brewster offices. To schedule an appointment with her, call MKMG at 242-1355 or 845-278-4300.


 



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