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About Strabismus

What is strabismus?

Strabismus is when two eyes look in different directions. One eye is looking straight ahead while the other is looking inward, outward, up, or down. Patients with strabismus can sometimes look straight with both eyes in different head positions, such as tilting their heads to the right and left. Sometimes strabismus can manifest itself with such head position abnormalities.

Who gets strabismus?

Although it is usually seen in children, it can also occur at older ages. Strabismus is found in 5% of all children and 1% of adults. It occurs with equal frequency in both sexes. Except for some rare types, it usually does not show a genetic transition.

Do our two eyes work together?

Vision is an event that takes place in the brain. The eye is the organ of emotional perception. The image formed as a result of the stimuli received by the retina is transmitted to the visual cortex in the brain via the optic nerve and visual pathways. Apart from this emotional system, there is a motor system (non-ocular muscles) that is used to turn both eyes towards the relevant object and to create the same image in both retinas. Normally, our eyes look at the same point, and the two images transmitted to our brain from both eyes are combined (fusion) by our brain, allowing us to see in three dimensions (stereopsis). In short, it is provided by our eyes and movement centers in our brain and 6 muscles outside the eye.

When one eye looks in a different direction, two very different images will appear in our brain. In this case, the image coming from the opposite eye to the brain will either be ignored (development of amblyopia) or suppressed (development of suppression). The brain will only accept the image transmitted by the eye looking forward. If this happens in childhood, adaptation mechanisms develop, which cause serious problems such as lack of sense of depth and low vision in the eyes (laziness = amblyopia). In adult strabismus, on the other hand, the brain does not perform the adaptation mechanisms as in children, and double vision occurs by accepting both images.

What are the causes of strabismus?

The exact reason is unknown. Genetic transmission can be seen in some families. It can only occur due to refractive error, but also congenital brain damage, mongolism, brain tumors, a cataract that reduces vision, eye injuries, or tumors that can cause strabismus.

If strabismus has not existed before and has just occurred in adult age, diabetes, multiple sclerosis, thyroid disease, myasthenia gravis, and other diseases related to the central nervous system should be investigated.

What are the symptoms of strabismus?

  • Eyes looking in the same direction
  • The disappearance of the three-dimensional image
  • Blurred vision
  • Head or face turned to one side
  • Eye-watering
  • Pain
  • Headache
  • Double vision

There may also be symptoms such as tilting one's head to one side or looking away from one eye to use one or both eyes in a sunny environment.

All children need to be checked by an ophthalmologist within the first 3 years of age for the child's vision development. If there is someone else in the family with strabismus or lazy eye syndrome, this examination should be done before the age of 3 years.

Apart from cosmetic discomfort of strabismus in adults since childhood, if the patient has not been treated well, there may be vision problems, the laziness of vision. However, if strabismus has occurred at an older age, the most common symptom is double vision. In some adults, symptoms such as eye pain, headache, and keeping the head tilted all the time can be found.

 

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