What is strabismus?
Your two eyes usually work together so they are both looking at the same object at the same time. If the two eyes tend to point in different directions some or all of the time, the condition is called strabismus.
Why do people get strabismus?
Some people are born with eyes that do not align in the usual way, which is called congenital strabismus. In many children, there is no clear cause of strabismus. In some cases, it is a result of a problem with the nervous system, especially the part that controls the muscles of the eyes.
Strabismus in children can be corrected with a surgical procedure. If it is not corrected, strabismus can continue into the adult years. Most adults who have strabismus were born with it.
Someone who is born with strabismus will see without having double vision. There might be other effects on vision, however. Because the two eyes are not working well together, depth perception and peripheral vision (vision off to the side) will not be very good. Eye strain and headaches can occur frequently. It might also be necessary to turn the head in unusual ways in order to see in certain directions.
In addition to these problems, strabismus also affects a person's appearance. Because eye contact is important in our communication with others, having eyes that point in different directions can be disturbing.
If strabismus does not appear until later in life, it will cause double vision. If the eyes become misaligned in an adult who did not have strabismus as a child, it could be a sign of some other condition. Some of the conditions that cause strabismus in adults can be serious. Strabismus could be a sign of stroke, a condition of the thyroid gland or another health problems. A sudden misalignment of the eyes or double vision are important reasons to see a doctor immediately.
Is there any way to align the eyes of an adult who has strabismus?
Only a doctor can recommend the right treatment for someone with strabismus, and that requires a careful examination. The doctor will have to make sure there is no other condition that is causing the strabismus. If not, the treatment might be a new prescription for eyeglasses. Eyeglasses will only correct small amounts of strabismus, however.
For people with a greater degree of strabismus, the doctor might recommend a surgical procedure to realign the eyes.
What happens in surgery for strabismus?
Strabismus is corrected by "strengthening" or "weakening" the effect of one or more of the muscles that move the eye.
When this procedure is performed on adults, it is usually done under local anesthesia - that is, the patient is awake but does not feel the procedure.
The surgeon will first make an opening into the outer layer of the eyeball. This allows the surgeon to reach the muscle that will be "strengthened" or "weakened."
Strengthening the muscle means removing a small section from one end and then stitching it back together with sutures. This makes the muscle shorter, which tends to turn the eye toward the side of that muscle.
"Weakening" the muscle means making a cut across one end, but not removing any of the muscle to shorten it. Instead, a gap is left where the muscle was cut, and the ends of the muscle are tied back together with a loop of suture. This has the effect of making the muscle longer, which lets the eye turn further away from the side of that muscle.
At the end of the strabismus correction procedure, the surgeon will close the opening in the eye with stitches. The patient will often have double vision for a few weeks after surgery. This goes away as the brain adjusts to the new way of seeing.
How successful is surgery to correct strabismus in adults?
Muscle surgery for strabismus usually aligns the eyes very well. In some patients, however, a second procedure is needed to perfect the alignment. Once the two eyes are working together, the patient almost always benefits from better vision and a more normal appearance.
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