Corinne Odineal, OD, FCOVD
Strabismus is commonly known as “wall eyed” or “cross eyed” when a person’s eyes are not in alignment. The eyes may turn in, out, up or down and may be turned some of the time or all of the time. When the eyes are not aligned, information about the world is confused, sometimes seen as double, but may also be “suppressed” by the brain to avoid confusion.
Strabismus has different causes. The condition is usually caused by poor eye teaming skills which include confusion in the signals traveling between the eyes and the brain. When the two eyes work together, a person will have better overall visual skills. The younger the child, the easier it is to learn correct vision habits. Therefore, early detection and treatment of strabismus and functional problems by an optometrist is important. Strabismus can also be caused by trauma, fever, a missing muscle (rare), spastic muscle control, nystagmus, infections, paralysis, stroke or eye scarring.
Treatment depends on the diagnosis of the type and severity of the problem, as well as how deep the adaptive process has become (suppression). The optometrist that specializes in vision therapy will determine the prognosis and individual treatment plan for the patient. The treatment begins with the proper prescription and then leads to developing each eye’s independent and equal skills in eye movement, focusing, visual perception and spatial perception. The treatment may include various activities to develop gross motor and laterality skills overall. The doctor will use various lenses, prisms, filters and instruments to train the eyes and the brain. Patching may be used for part of the therapy. Ultimately, the doctor’s goal is to help the patient regain binocularity (two-eyed vision) and often, stereopsis (depth perception). Treatment for strabismus can be complicated and lengthy. The patient, or parents and child need to be committed to daily eye and brain exercises, but the rewards of treatment are significant in providing better function, as well as cosmesis.