Early detection is key in infantile strabismus

Infantile strabismus is the loss of parallelism of the eyes. The deviation can be inward (convergent strabismus), outward (divergent strabismus) or vertical (upward or downward).

The cause of strabismus is multifactorial and many of the triggers are still unknown. What is certain is that about 97% are of functional cause, i.e. without any organic brain lesion. In the rest it is accompanied by neurological, metabolic, vascular or malformative diseases of the central nervous system.

This pathology can appear at any age. In most cases, infantile strabismus usually appears before the first year of age. Late strabismus, above three years of age, is usually due to uncorrected refractive problems (especially hyperopia). Once established, strabismus does not disappear spontaneously.

Childhood strabismus: symptoms

The most apparent symptom is the deviation, which is the warning sign that forces parents to consult an ophthalmology specialist. However, the deviation brings with it a series of “non-visible” consequences:

  • Amblyopia or lazy eye: the deviated eye is cancelled so as not to see double.
  • Loss of binocular vision and consequently of stereopsis.

These alterations are more serious the earlier the age of onset of strabismus.

Can infantile strabismus be prevented?

Strabismus cannot be prevented. However, early detection is very important in order to treat it as quickly as possible and to try to reverse the consequences mentioned above. In this sense, ophthalmologists receive great help from pediatricians who are the ones who have the most continuous contact with children, who know this pathology perfectly well and promptly refer children to the specialist.

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In any case, and as a rule, all children (even if parents do not notice anything) should be examined by an ophthalmologist at the age of three. In cases where there is a family history of strabismus or lazy eye, the examination should be even earlier.

Treatment of childhood strabismus

There is no standard treatment for strabismus although a therapeutic algorithm can be established. First of all, a refractive error must be ruled out and, if it exists, the prescription of corrective lenses is necessary.

If amblyopia is present, it should be treated by the various methods available depending on the severity of the amblyopia (occlusion, penalties, etc.). Finally, a surgical intervention will be performed in all those cases in which the deviation causes a sufficiently noticeable esthetic defect.

The treatment of strabismus is long and needs to be monitored for many years. Unfortunately, surgery must be repeated in 30% of cases. The reason for this high number of failures is that the brain of the child suffering from infantile strabismus does not always accept as good the position induced by surgery and tends to bring the eye back to the primitive position.