Strabismus: Functional vision restoration is essential during early childhood

Strabismus, which is usually hereditary, occurs in the first years of life and varies according to degrees of divergence (variable angle of strabismus).

In rare cases, the disease occurs in adulthood due to various causes (thyroid disease, ischemic stroke, diabetes, multiple sclerosis, brain tumors, brain trauma)

In greater detail, the main causes of strabismus are heredity predisposition, a number of brain diseases but also systemic diseases (diabetes, thyroid disease). Strabismus during early childhood is due to refractive problems. However, in rare cases it may be due to other pathological causes or might gave neurophthalmic pathology.

Strabismus: What happens and the eyes are not aligned?

In normal vision, the axes of the eyes are kept in alignment and the harmony of the muscles of one eye with the muscles of the other is achieved, through the command received by the cranial nerves.

However, in Strabismus these axes are not parallel and as a result, this co-operation cannot be achieved.

Strabismus affects patient’s visual ability

Strabismus most often affects the function of vision itself and does not present only as an aesthetic problem. The main feature is the loss of stereoscopic vision (depth dimension).Double vision (Diplopia) often occurs where the brain repels the deviating eye image.

Children who develop Αmblyopia reject the image of the incorrectly aligned eye (lack of synapses between the brain and the eyes). Parents may notice uncoordinated eye movement of their children, tilting of the head to one side, one-eyed distraction.

Functional vision restoration should be performed as soon as possible in children.

The simplest and most reliable way to diagnose strabismus is the cover test and it is used mainly in children under the age of 3. The ophthalmologist covers the child’s eyes (one at a time), either with his hand or with an appropriate cloth, for 2-3 seconds. In that way he can observe the movement of each eye separately.

In a child without strabismus, this procedure doesn’t cause any eye movement. As the Cover test is a fairly sensitive test and provide the physician with  a clear answer regarding each case.

Light reflex procedure evaluates the alignment of the eyes by having the child to look directly at a point of light. Other tests use prisms for the analysis of child’s visual ability and for older children standard eye charts with either letters or pictures are used. All of the above are examined by the ophthalmologist in addition to the medical history of the child and his/her hereditary disposition.


After the child reaches the age of 6 months, the treatment of strabismus begins with the eye covered for some hours a day. This process irritates the eye which results in the development of visual acuity. In some cases of stress, the problem can be resolved simply by constantly wearing glasses. Examination by a specialized doctor every 6-12 months is considered necessary. The most difficult cases are treated surgically, where the doctor strengthens or weakens the muscles to align the eyes. If the problem of strabismus is very serious, then there is the possibility of a second surgery.


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