4 solutions for adult-acquired strabismus

In the ophthalmology office there are many cases of individuals who have developed normal binocular vision and, in adulthood, present strabismus. This group includes strabismus that develops from second childhood onwards.

Causes of strabismus in adults

Strabismus in adulthood is caused by four main groups:

• A large part of adults who develop strabismus already had it since childhood in a controlled manner and are usually kept compensated with optical correction.
• On the other hand, there are strabismus caused as a consequence of systemic diseases such as:
  • Diabetes Mellitus
  • Hyperthyroidism (Graves’ disease)
  • Cerebrovascular accidents
  • Myasthenia gravis
  • Pathologies of the central nervous system
• Low visual acuity of the deviated eye: this is the case of diseases of the eye that cause very low visual acuity. In these cases low vision is the cause of strabismus.
• Secondary strabismus due to ophthalmologic interventions such as cataracts, vitreoretin and oculoplastics.

Symptoms of adult strabismus

An adult who develops strabismus may manifest:

• Diplopia or double vision
• Visual fatigue
• Confusion of images (vision of superimposed images)
• Loss of depth perception
• Altered head position (twisting of the neck to compensate and avoid diplopia).

4 treatment options for strabismus in adults

1. Vision therapy: especially indicated for convergence insufficiency.
2. Prism glasses: Indicated to correct small angle deviations. The prism is a lens that deflects the course of light rays and therefore the image. In this way it alleviates diplopia. They can be prisms that are attached to the glasses (Fresnel prism) or incorporated directly into the prescription lenses.
3. Botulinum toxin injection: indicated if there are overactive muscles, usually secondary to the fact that the muscle that performs the opposite action is weakened or paralyzed. Its effects last for months and may require reinjections.
4. Extraocular muscle surgery: fortunately, surgery can be performed to compensate for the muscle problem causing the deviation.