Early treatment can help prevent vision loss in children with Strabismus
Contributing columnist January 31, 2015 

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Strabismus is a condition in which the eyes are not aligned. The condition can be identified at any age, but is most commonly identified in children. The eyes can be drifting out, in, up, or down.
According to the American Association for Pediatric Ophthalmology and Strabismus, an estimated that 4% of the U.S. population has strabismus.
For the first few months of life, some malalignment of the eyes may be normal, but by four to six months old the eyes should be aligning normally. Strabismus can show up in infants, around age 2 or 3 or even older. It can also occur in adults.
It is important to consult with a physician as soon as you notice any potential concern with your child’s vision. Although rare, strabismus can be an indication of a neurological problem, especially in adults. If strabismus in a child is not corrected, the eye that is deviated can develop amblyopia, or lazy eye, which can lead to decreased vision in that eye.
If you notice the eyes are not aligning normally even just periodically, take a photo as a reference and consult with a physician.
A pediatric ophthalmologist can assess your child’s vision even before your child can recognize letters or numbers. Even if a child is too young to talk, an ophthalmologist can use special instruments to determine an appropriate glasses prescription.
During a typical exam, a child’s eyes would be dilated to check health of the eye.
An ophthalmologist can determine if one eye is stronger than the other, check motility of eyes to be sure they can move in all directions and identify concerns with the alignment of eyes. Using prisms, ophthalmologists can even determine how much the eyes are drifting.
Up to age 9 or 10, a child’s vision pathways are still developing, which is an asset in vision correction. This ongoing development means that you may be able to recover vision that is lost up to that age.
While strabismus can be concerning for parents, there are multiple options for treatment, some as simple as a glasses prescription. Patching the better seeing eye can help sight to improve in the eye that has poorer vision. More difficult cases to correct may require surgery.
Surgery to correct strabismus is done as an outpatient and the procedure takes about 30 minutes to an hour. Children are at the hospital about four hours total, and typically bounce back to daily activities within a couple days.
Roughly 80 percent of patients surgically treated for strabismus never need another surgery. The remaining 20 percent may need an additional surgery either during childhood or as adult to correct the condition.

Dr. Palak Wall is a pediatric ophthalmologist with KentuckyOne Health Pediatric Ophthalmology, Saint Joseph East


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