Estrabismo pediátrico

Strabismus

Strabismus is associated to any kind of eye misalignment. There are many different types of strabismus and they are usually described according to the direction of the deviation. The most common types are endotropia (convergent deviation), esotropia (divergent deviation) and hyperopia (vertical deviation). Special strabismus patterns can have unique names, such as Brown syndrome and Duane syndrome. Most types of strabismus result from an anomaly in the neuromuscular control of eye movement. We still rely on an incomplete understanding of these brain-located control centers.

 

Strabismus may cause amblyopia in children. When eyes are oriented towards different directions, the brain receives two different images. When trying to avoid diplopia (double vision), a children’s brain can adapt itself by ignoring the image of the deviating eye, which results in a poor vision development of that specific eye. This occurs specially during early childhood.

Generally, strabismus develops in healthy children. Nevertheless, disorders affecting the central nervous system such as cerebral palsy, Down syndrome, hydrocephaly and brain tumours increase the propensity to develop this illness.

In adults, strabismus is usually caused by cerebrovascular accidents or other vascular problems. Head and orbit traumas or various neurological and endocrinal diseases (such as thyroid-associated orbitopathy) are other common causes. Unlike children’s, an adult’s brain does not have the same adaptive capacity. Therefore, diplopia is the predominant symptom.

The aim of the treatment is to increase the eyes’ alignment, not only for aesthetic purposes but also to enable their collaborative work (binocular vision), thus nullifying diplopia if it is present. Treatment might involve eyeglasses, orthothetic treatments prisms and extra-ocular muscles surgery.

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