Types and treatment of strabismus
Pediatric Eye Clinic
Regarding its classification, strabismus is divided into four types:
Esotropias: Appears when the eyes are turned inward. This type is divided into accommodative (deviation of the eyes caused by an effort of accommodation as they try to clarify the image) and non-accommodative (which is usually due to a deterioration of the accommodative phase).
Exotropies: in this case the eyes are turned outward and their appearance is usually late.
Hypotropias: Patients who have this type of strabismus have a downward orientation of the eye.
Hypertropias: Finally, in this case the eyes deviate upwards.
Strabismus should never be ignored in the belief that the child will heal itself. Unless it is treated before the age of 9, it can lead to permanent loss of vision in the deviated eye (amblyopia). Amblyopia develops faster in young children and takes longer to correct in older children, so the earlier treatment is started, the less severe the initial visual defect and the faster the response. Likewise, strabismus is sometimes a premature sign of a serious nerve disorder.
There are numerous techniques to correct this disorder; such as special glasses, shutter of the dominant eye alternately with the other and visual training programs to reinforce binocular vision. In any case, early detection is essential to establish muscular balance, that is, to regain the parallelism of the eyes.
Surgical treatment is indicated in severe cases or those that are not corrected with traditional treatments.
Surgery consists of strengthening or weakening certain muscles of the eyes to obtain good vision and prevent them from twisting. This treatment can have complications, such as the appearance of infections, allergic reactions or drooping of the upper eyelid.
Sometimes strabismus can be corrected by injecting botulinum toxins and under general anesthesia. These toxins produce a temporary paralysis of the muscles and allow, by a series of mechanisms, and, in some certain cases, to cure this disorder.
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