At the age of 2.5-3 years, the child's vision should be fully coordinated. If the baby is sick with strabismus (strabismus), it is important to immediately visit the ophthalmologist and begin a comprehensive treatment. Without proper therapy, irreversible complications can occur, and visual acuity will deteriorate rapidly.
Types of strabismus
The classification of strobism is carried out according to the following criteria:
- the plane of the pupil deviation from the normal position;
- eye involvement;
- stability of pathology;
- heaviness;
- the main reason;
- external expression.
By the deviation of the pupil from the correct axis, the strabismus in children is divided into the following groups:
- divergent;
- convergent;
- vertical;
- mixed.
In accordance with the involvement of the eye pathology is differentiated into 2 types:
- monolateral;
- alternating.
According to the frequency of manifestation, Strabismus has 2 forms:
- constant;
- periodic.
Degrees of the disease according to the angle of the eye's deviation from the center line:
- minimum (up to 5 degrees);
- light (6-10 degrees);
- average (11-20 degrees);
- high (21-36 degrees);
- Heavy (more than 36 degrees).
It is also important to determine the origin of strabismus in children - the causes and treatment of strabismus are closely interrelated. If the pathology is paralytic, it provokes muscle dysfunction. In such cases, only one eye always mows, it is static or strongly limited in mobility. It is difficult to cope with this form of strabismus. A friendly type of disease is characterized by a deviation from the right axis of both eyes alternately. This type of strabismus is classified into subgroups according to the age at which it debuts in the child:
- accommodative - about 3 years;
- partially accommodative - 1-2 years;
- non-accommodation - any time period.
By external expression differentiate such forms of strabismus:
- false (imaginary) - absence of oculomotor disorders;
- latent - the asymmetry of pupils is determined only when one eye is closed;
- true - visually noticeable problem.
Divergent strabismus in children
The described type of strabismus or exotrophy is characterized by a deviation of the pupil towards the temple. Diverging friendly strabismus in children is often found in combination with other visual pathologies, especially nearsightedness. With paralytic exotrophy the pupil either does not move at all, or moves very limited due to disruption of the muscles and nervous conduction.
Convergent strabismus in children
The considered form of pathology (esotropia) is the displacement of the pupil to the bridge of the nose. Convergent friendly strabismus in children is also diagnosed in conjunction with diseases that cause deterioration of visual acuity, mainly farsightedness. In the case of paralytic esotropic strabismus, the pupil is constantly near the bridge of the nose and practically does not move.
Vertical strabismus in children
There are 2 variants of this variant of the disease:
- hypertropy - the eye shifts upwards;
- hypotrophy - the pupil "falls" downwards.
There are also mixed types of strabismus in children, when the different forms described above are combined. The following types of mixed strobism are more often diagnosed:
- exotrophy with hypotropy;
- esotropia with hypertropy.
Imaginary strabismus in children
To establish the truth of strabismus and confirm the alleged diagnosis can only an ophthalmologist with the help of special tests. False strabismus in children is often suspected in infancy. The impression of pupil asymmetry arises from the peculiarities of the skull structure in infants. In the corner of the eye they still have a massive skin fold, and the nose is too wide. After a few months, the bones and cartilage are re-formed, and the vision of the baby becomes focused.
Still there is a hidden strabismus in children. It is characterized by underdevelopment of visual muscles. The peculiarity of the presented form of strabismus is the outwardly normal work of the pupils, when the child looks with both eyes. The inconsistency of their movements is noticeable only when carrying out a special test. If one eye is closed, the second pupil deviates from the axis. Such strabismus is difficult to identify independently, so parents should regularly take their children for routine examinations to the ophthalmologist.
Strabismus - the causes of
There are 2 main factors that cause the problem in question at an early age. To develop effective treatment it is important to find out exactly what triggered the development of pathology. The causes of strabismus in children are divided into the following types (described in detail below):
- congenital (hereditary) - strabism is present from infancy;
- acquired - the disease will debut after 1 year.
Congenital strabismus in children
Infants are necessarily examined by an ophthalmologist, primary consultation is performed in 1 month. The specialist knows how to determine the strabismus in a child even at such an early age, therefore, doctors should not miss receptions. Strabismus can be present from the moment of birth, but it is difficult to diagnose it on its own. The causes of strabismus in infants:
- the Louis-Bar syndrome;
- birth trauma;
- pathology of pregnancy;
- Brown's syndrome;
- fetal hypoxia ;
- dysfunction of the development of the nervous and muscular system;
- umbilical cord entanglement and others.
Acquired strabismus in children
If at birth the vision of the baby was in order, but later appeared strabism, it is necessary to find the factors that provoked its development. After their elimination, it is easier to correct strabismus in children - the causes and treatment of pathology are directly dependent on each other. Acquired strabism can arise against the background of the following problems:
- retinal dystrophy ;
- short-sightedness ;
- cataract;
- farsightedness;
- damage to nerve endings;
- mechanical injuries;
- infectious diseases;
- severe stress;
- neurosis ;
- lesions of the cerebral cortex or pituitary gland;
- fright ;
- tumors;
- thyroid disease and others.
Some parents observe such a phenomenon as a sudden strabismus in a child. Strabism never appears unreasonably. There is a possibility that the pathology developed latent, or the angle of the pupil deviation from the normal axis was previously too small. For correct therapy, it is important to undergo all diagnostic procedures and be sure to determine visual acuity.
How to cure strabismus in a child?
To normalize the position of the pupil it is necessary to find out the form of strabismus, its degree and causes. Treatment of strabismus in children is developed individually by an ophthalmologist. Depending on the type of disease, the therapy may include:
- wearing special tools;
- medicamentous effect;
- doing gymnastics for the eyes;
- hardware treatment;
- surgical intervention.
Is it possible to correct strabismus in a child?
Some parents believe that it is impossible to restore normal sight to a baby. Ophthalmologists respond positively to the question of whether strabismus is treated in children. Modern therapeutic methods provide guaranteed and sustainable results. Even with the ineffectiveness of conservative methods of treatment, it is possible to perform an operation that corrects strabismus in children in any case, including congenital and paralytic forms of strobism, regardless of its causes.
Therapy of the described illness is long and gradual. It should appoint an ophthalmologist after a thorough diagnosis. It is necessary to know why there was a strabismus in children - the causes and treatment are closely interrelated. The basic scheme assumes the following stages:
- Pleoptic. This stage is necessary for the gradual "equalization" of visual acuity in both eyes. Therapy includes instillation of special drops prescribed by an ophthalmologist, wearing medical lenses or glasses .
- Occlusive. The purpose of this stage is to transfer the visual load from a healthy eye to the patient in order to "turn on" it and get it to work properly. Used an occlusive dressing, which the child must wear constantly or a certain time. It closes only the healthy eye.
- Orthoptic. After the normalization of visual acuity, it is necessary to "teach" the eyes to correctly transmit information to the brain, to combine images obtained from 2 retinas into one correct picture. Special eyepieces and progressive computer technologies are applied.
- Diplomatic. The final stage of treatment, providing clarity and speed of focusing, the final strengthening of visual acuity.
Exercises with strabismus in children
Gymnastics is selected only by an ophthalmologist after diagnosis and thorough individual examination. Self-treatment of strabismus in children at home through exercise for sight can end badly, lead to deterioration and irreversibility of the pathological process. Some kinds of gymnastics are dangerous to perform in certain forms of strabismus, therefore this method of therapy can be recommended only by a doctor.
Hardware treatment of strabismus in children
The use of advanced technologies is included in almost all conservative therapy regimens. This is one of the most effective ways to treat strabismus in children without surgery. Studies using computer devices successfully replace obsolete exercises at home. Positive results are achieved much faster.
Such methods of therapy are considered as the safest option, how to eliminate strabismus in children - the causes and hardware treatment are determined by the doctor, so the risk of making mistakes is excluded. Classes with instruments are designed specifically for toddlers, they are implemented in a playful form. In modern ophthalmological clinics the following equipment is used:
- Reamed;
- Synoptophore;
- Ambliocor;
- Forbis;
- Musculotrener and other apparatuses.
Operation with strabismus in children
If no conservative therapies have helped, surgical intervention is prescribed. According to statistics, this is the only method how to correct strabismus in a child, the necessary 85% of children suffering from strabismus. Ophthalmic surgery is constantly evolving, so modern operations are painless, minimally invasive and suggest a short rehabilitation period. Before choosing an option for the procedure, it is necessary to know why the strabismus occurred in children - the causes and treatment are strongly interrelated.
All kinds of surgical intervention consist in changing the work of the visual muscles. Manipulation can be aimed at strengthening or weakening their traction, correcting the direction of movement. After surgical procedures, the position of the eye is completely normalized, and conservative treatment aimed at improving visual acuity is carried out.