Paralytic strabismus (ICD-10 - H49) is a fairly rare and very undesirable phenomenon that can occur in people of all ages. Let us further consider the main features of this eye pathology, its symptoms, causes of formation, as well as possible treatment options.
General characteristics
Speaking about the general characteristics of paralytic strabismus and the treatment of pathology, it is worth noting its main features.
The problem under consideration appears visually - a person begins to noticeably mow one eye. As for the patient himself, he can diagnose the presence of such a problem on his own, without the help of outsiders, because with this pathology there is a significant distortion of the visible picture of the surrounding world. Practice shows that in the presence of the defect in question, a person cannot normally perform even the simplest work.
Specialists in the field of ophthalmology say that if you ignore the problem, you can get serious vision problems, up tocomplete loss. However, it is worth noting that with the timely and competent elimination of the pathology, such a danger can be guaranteed to be avoided.
Determination of pathology
How is the violation in question determined? It is worth noting that the diagnosis of paralytic strabismus can be made even visually, however, any ophthalmologist, conducting an examination, is obliged to study the problem in more detail, making a number of specific measurements, as well as assessing the field of view. All of the above actions are carried out by carrying out the following procedures in the prescribed manner:
- Examining the eye with an ophthalmoscope and determining the angle of view by measuring the angle of light reflection.
- Assessment of the area of binocular vision using a synoptophore.
- Using a prismatic compensator to determine the angle of error.
In the process of diagnosing pathology, to study the nature of binocular vision impairment, multi-point text of a color type can be used. Regarding the process of separating the fields of the right and left eyes, the ophthalmologist can use the skills of coordiometry.
It should be noted that after all the procedures necessary to establish paralytic strabismus and confirm the problem, the patient must be referred to a neurologist.
Equipment used for diagnostics
For a more accurate determination of the features of the visually observedpathology, as well as the reasons for its formation, modern medicine uses several types of equipment. Most often, to investigate the nature of the problem, the following is assigned:
- computed tomography of the brain or its study using MRI;
- orbital computed tomography;
- electromyography.
It should be noted that any of the listed procedures should be carried out along with the measures described above for diagnosing the disease in question. When studying the results obtained during the diagnostic manipulations, the presence of some and other specialists is important, among which there must be professionals in the field of neurology and infectious diseases.
Symptoms of pathology
The problem in question has a number of symptoms that make it fairly easy to identify. These include the following indicators:
- lack of eye movement (or observation of low mobility);
- double vision;
- constant presence of deviation;
- difference in deviation angles (primary less than secondary);
- presence of dizziness;
- observation of voluntary deviation of the head towards the affected muscle (torticollis).
It should be noted that there is actually a major difference between paralytic and concomitant strabismus. It lies precisely in the last presented sign. This is due to the fact that atconcomitant strabismus, involuntary head turns are not observed.
Reasons for education
Specialists in the field of medicine name a number of reasons why the pathology in question can form. Among the main causes of paralytic strabismus in adults, it is worth highlighting:
- presence of purulent inflammation in the area close to the optic nerve;
- toxic damage to the eyeball;
- presence of eye injuries;
- the presence of diseases whose action is aimed at damaging the central nervous system (in particular, the optic nerve);
- presence of various types of tumors;
- myositis;
- neuritis.
Specialists in the field of ophthalmology note that the most common cause of the pathology in question is injury to the eyeball. As a rule, the causes of this type of dysfunction can be both domestic and industrial.
Types of pathology
It is worth noting that paralytic strabismus that develops in humans can acquire different types. Currently, in medical practice, there are several variants of the pathology under consideration, the classification of which is made depending on the location of the pupil of the eye and the possibility of its movement. Of the varieties of paralytic strabismus, it is worth highlighting:
- horizontal (when pupil deviation occurs to the left or right);
- vertical (in case of pupil deviation down or up);
- permanent/temporary;
- two-sided, one-sidedor intermittent.
The types of pathology considered can be both acquired and congenital, but each of them always affects only one eye.
As for the forms of pathology, depending on the location of the pupils, it can be characterized as:
- vertical;
- divergent;
- convergent.
As for divergent strabismus, this pathology, as a rule, occurs against the background of myopia. In such a situation, the patient's eye is directed towards one of the temples. In the absence of myopia, the manifestation of this form of pathology is usually associated with the transfer of infection. When the eye is tilted up or down, the strabismus will be called vertical.
As for convergent paralytic strabismus, it is observed, as a rule, in childhood. Practice shows that such a pathology is often temporary and in the early stages is quite easy to complete treatment. When observing such a problem, the eyes of a person are directed towards the nose. In adults, this type of pathology is often associated with farsightedness.
It should be noted that the pathology in question can manifest itself in three other forms, depending on the nature of its origin: orbital, nuclear and stem. Let's talk about them further in more detail.
Nuclear
The development of this type of strabismus can only be associated with an infectious lesion of the nuclei of the brain, and can also occur with other diseases that havedetrimental effects on the body, as vivid examples of which can be:
- encephalitis;
- multiple sclerosis;
- neurosyphilis.
which can lead to the most unfortunate consequences.
Stem
Speaking about the stem form of pathology, it is worth noting that its manifestation is associated primarily with the presence of damage localized at the level of the brain stem. Due to this factor, this form of paralytic strabismus is often referred to as basal. As for the nature of the occurrence and further development of the pathology, it can be:
- angiogenic;
- toxic;
- traumatic;
- infectious.
Orbital
As for the orbital form of paralytic strabismus, its treatment is most successful and, according to statistics, gives the greatest number of favorable outcomes. The main etiological factor of this type of lesion, as a rule, is a subperiosteal abscess or periostitis. Practice shows that the method of treatment of the considered form of the disease is based on the complete removal of the process that provokes a change in the normal functionality of the organ of vision. Statistics show that after all the necessaryoperations, visual acuity is restored to the maximum or in full.
Pathology in children
It is known that paralytic strabismus is often observed in children who have just been born. Pathology belongs to the category of congenital and is formed in the womb.
The main reason for the appearance of the considered eye disease in a child is the presence in the mother's body of complex infections that affect the development of the child's central nervous system. Also, the cause of this phenomenon may be the mother's abuse of bad habits in the process of bearing the fetus.
It should be noted that recently paralytic strabismus has become quite often diagnosed in children - 2-3 times more often than in adults. If the problem is ignored, the baby may experience dysbinocular amblyopia, the development of which at one moment begins to occur rapidly.
Treatment
In order to eliminate a visual defect, medical specialists conduct a complete examination of the patient, as a result of which the underlying nature of the disease must be established. Once identified, a treatment plan can be developed, which usually includes surgery for paralytic strabismus to restore eye symmetry.
In the event that the problem does not have an advanced form, then it can be eliminated by medication. In addition, a number of effective manipulations also include reflexology, electrophoresis andelectrical stimulation.
Rehabilitation period
After carrying out all the procedures prescribed by the indicated course, it is necessary to exclude excessive eye strain, and also regularly perform special exercises prescribed by an ophthalmologist.
Special attention should be paid to the fact that in the postoperative period it is necessary to wear special glasses designed to cover the operated eye from the sun, as well as protect the he althy one.
It should be noted that the procedure for treating strabismus is a rather lengthy process that can take a couple of years, as for the rehabilitation period, it takes about six months.
Folk methods for improving vision in the rehabilitation process
During the course of the rehabilitation period, you can take care of your eyes with the help of products prepared according to folk methods. It should be noted that before using them, you need to consult with the attending ophthalmologist, indicating the features of the composition of each remedy.
Currently, among the most effective methods of restoring visual acuity in the postoperative period are phytodrops and decoctions made on the basis of natural ingredients. Consider further some recipes for their preparation.
Phytodrops from dill seeds. To prepare an effective remedy for this recipe, you need to take 10 g of powder made from dill seeds and pour the component with a glass of boiling water. An infused and filtered remedy must be instilledoperated eye three times a day, a couple of drops.
Decoction of pine needles. In order to prepare an effective product made on the basis of pine needles, it is necessary to pour 100 g of the main component with a glass of boiling water, and then let the mass brew for an hour. After the allotted time, the decoction must be consumed. To obtain a positive effect, the use of the product must be repeated three times a day.
Phytodrops with honey. In order to make effective phytodrops, you need to mix 3 drops of apple and onion juice in one bowl, and then add 1 drop of natural liquid honey to these components. After mixing, pour a spoonful of boiling water into the mass and let it brew in a corked form. An infusion should be instilled daily into the eyes before going to bed. Reviews of this vision sharpening technique very often say that it becomes clearer in the morning.
