Alternating strabismus is a fairly common defect among children and adults. This is not only an aesthetic flaw or a cosmetic defect, but a truly serious disease that develops for many different reasons. Treatment of alternating strabismus should be started as soon as the first signs appear. Otherwise, the patient runs the risk of saying goodbye to vision altogether.
General information
Code of concomitant convergent strabismus according to ICD-10 - H50.0.
Strabism is a disorder in the work of the eye muscles. There are many varieties of this pathology, which differ in localization and degree of complexity. An important condition for correct treatment is the correct diagnosis.
Alternating strabismus is a form of concomitant strabismus, which is characterized by alternate deviation of the eyes from the central axis. The main prerequisite for the development of pathology is a violation of the functioning of the muscles of the visual apparatus. Most often, the disease begins in childhood.
Reasons
The treatment of strabismus in children and adults only partly depends on the underlying prerequisites forthe development of pathology. After all, the pathogenesis of strabismus has not yet been studied. True, doctors mention a hereditary factor in the etiology of pathology. It is genetic defects that can become a catalyst for the onset of an eye disease.
The chances of developing alternating strabismus in a child, just like any other of its forms, increase significantly if a woman, while in a position, smoked, abused alcohol or took powerful analgesics. Another cause of strabismus is preterm labor.
If the disease is acquired, then it manifests itself almost imperceptibly and gradually.
The most common causes of concomitant strabismus are:
- myopia;
- benign and malignant neoplasms;
- myopia;
- myasthenia gravis;
- cataract;
- constant stress;
- farsightedness;
- astigmatism;
- thorn;
- optic nerve atrophy;
- damage to the visual system and paralysis;
- retinal detachment.
Adults are exposed to the disease most often due to infection in the body and against the background of eye injuries.
Clinical picture
Converging alternating strabismus most often occurs in childhood. It may be of a non-permanent nature until the moment when the visual apparatus begins to exclude the picture that falls into the field of a beveled apple.
Over time, the brain gets used toto the fact that images seen by two eyes prevent each other from creating a single object. As a result, visual analyzers simply stop responding to pictures coming from a diseased nerve.
Gradually, vision becomes monocular, and the pathology itself becomes more pronounced and permanent. Intermittent converging alternating strabismus is quite often accompanied by moderate or high hyperopia. Its origin is characteristic of early childhood and the neonatal period.
If strabismus is provoked by paralysis, there is a slanting of only one eye, which is either completely immobile or its muscles partially move. This clinical picture has many features:
- binocular vision is impaired;
- double vision is present;
- chronic dizziness;
- The head involuntarily turns towards the paralyzed muscles.
Converging paralytic strabismus (according to the ICD-10 code, see above) is often the result of background pathologies, harmful factors or damage. This type of strabismus can develop at any age. The cause that provokes the occurrence of paralysis of the muscles of the visual apparatus may be intoxication of the body.
Signs
Alternating strabismus is accompanied by the following symptoms:
- diplopia;
- discoordination;
- dizziness;
- migraines;
- decrease in visual acuity.
Pathology progresses with age. A congenital anomaly appears, as a rule, in 2-3 years. Treatment of pathology begins with the use of conservative medicine. The disease is directly related to the functioning of the brain.
Classification
Squint can be intermittent or permanent. In some cases, pathology occurs in stressful situations. And after the disappearance of the irritant, the problem also disappears.
Alternating strabismus can be convergent and divergent. In addition, doctors highlight:
- hidden variety, which is characterized by activation when the diseased eye is excluded from the visual act;
- an imaginary pathology, which is caused by the peculiarities of the anatomical structure of the skull and the placement of the eye sockets, usually the disease disappears with age;
- paralytic form, which appears due to failures in the functionality of the oculomotor muscles.
The causes of divergent strabismus are:
- differences in the level of vision;
- pathology of the retina or optic nerve;
- tumors in the brain, hearing aid, eyes or sinuses;
- malfunctions in the central nervous system.
How to detect such strabismus? A symptom of vice is the direction of one eye towards the nose when looking at a certain object. It is noteworthy that at the same time his muscles do not lose mobility. In addition, with such a pathology, diplopia does not occur.
Converging type of strabismus is usually accompanied by farsightedness. Doctors distinguish several varieties of this disease:
- congenital type is detected before six months, with it, as a rule, waiting tactics are recommended;
- acquired form is usually diagnosed in children under three;
- monocular defect - with it only one eye squints;
- alternating variety affects both eyes;
- paralytic appearance appears on the background of trauma to the brain, muscles or nerve.
Prognosis for such a disease is favorable, but by itself it will not disappear. Left untreated, convergent strabismus can lead to a number of complications:
- mental retardation;
- amblyopia;
- impaired vision.
Diagnosis and treatment
External signs of alternating strabismus can be determined by the patient on their own. The ophthalmologist after a visual examination determines the refraction and visual acuity, due to which it is possible to identify a type of pathology. Echobiometry can be used to measure the length of an apple. And its mobility and angle of deviation are revealed by the Hirshberg method.
Correction of strabismus requires an integrated approach and a long therapeutic course. In this case, the treatment is directed for the most part to the normalization of binocular vision. As a rule, regeneration occurs when the central nervous system is still able to control the sensory and motor function of the visual organs.
You can get rid of pathology with the help of such therapeutic and preventive measures:
- avoiding infections and damage;
- use of special glasses;
- diploptic exercises;
- control of the load on the visual apparatus, the choice of lighting;
- occlusion;
- surgical intervention.
Hardware therapy
For the treatment of alternating strabismus, specialists use the synoptophore device. Its main task is to connect the picture together. Machine in use:
- to determine the angle of strabismus and make all necessary measurements;
- diagnosing the general he alth of the retina;
- Binocular vision tests.
As already mentioned, the causes and treatment of strabismus in children and adults are directly related. It is thanks to this apparatus that it is possible to identify the prerequisites that influenced the development of the disease.
With the help of the synoptophore, you can detect a variety of anomalous processes:
- functional scotoma;
- fusion pathology;
- non-fovial compound.
Treatment of convergent strabismus
Visual abilities are finally formed, as a rule, by the age of 25. That is why therapy for alternating strabismus is carried out up to this age. Several treatment methods are used:
- Pleotic therapy. Through special computer technologies or a laser, stimulation is carried out, whichhelps to artificially increase the load on the damaged eye.
- Orthopedic way. Special computer programs and synoptic devices contribute to the normalization of binocular vision.
- Occlusion.
- Correction with special glasses.
All these therapeutic procedures are aimed at regenerating visual acuity, restoring connections between the eyes, activating the oculomotor muscles and correct placement of apples.
Treatment of divergent strabismus
The fight against anomaly consists of a whole range of therapeutic measures:
- optical correction - the use of special glasses or plastic lenses;
- hardware treatment improves visual acuity;
- diploptic technique that improves binocular vision performance;
- surgery.
As for outpatient therapy, it is used only in the initial stages of the development of pathology. Home treatment is reduced to strengthening the oculomotor muscles. Many patients use traditional medicine prescriptions for vision correction.
Surgery
Alternating strabismus rarely provokes complications, but if conservative methods do not bring the desired result, then the patient is shown surgical correction. It is needed if, due to strabismus, vision begins to deteriorate or other problems appear.
If we are talking about a small child, then the optimal age for an operativeintervention is considered 2-3 years. As a rule, there are no problems with recovery and vision becomes normal by the age of 6-7.
The operation is performed under local anesthesia, only occasionally under general anesthesia. To strengthen the oculomotor muscles, they are shortened.
Recommendations
The recovery period takes about a week. During this period, all physical activities are prohibited, and special eye drops are used to prevent complications.
For a month after surgery, you can not visit the solarium, swimming pool, sauna or swim in open water. But it is worth noting that the operation is not a panacea for alternating strabismus. In other words, after surgery, the prescribed therapeutic measures should be continued. For example, wearing glasses, applying eye drops, and exercising.
