Squint in a child is a pathological vision problem in which the position of the eyes is disturbed relative to the anatomically correct. There is deviation from the axis of vision. The child cannot simultaneously focus both eyes on the same object of study, which interferes with binocular vision, which is characteristic of a he althy person. Statistics show that strabismus occurs in almost 3% of children on the planet. It was not possible to identify dependence on gender, equally the problem can haunt both boys and girls.
General information
You can notice strabismus in a child if one eye (and sometimes both at once) deviates from the normal position. Another option for the development of pathology is the immobility of one eye. Usually, children suffering from such a disorder often squint, tilt their heads, reflexively trying to smooth out the imperfection of the visual organs.
Some believe that the described complexity is nothing more than cosmetic, but such an opinion is fundamentally wrong. Strabismusthe child indicates a malfunction of the visual system, and violations simultaneously affect several elements. In total, all this provokes quite serious he alth problems.
When a he althy child studies an object, in both eyes an image is simultaneously fixed on the retina, and it is located strictly in the central zone. This is due to focusing on one point. Such images, when processed by the brain, are superimposed one on top of the other, which makes it possible to obtain a complete picture of the surrounding world. Strabismus in a child causes different parts of the brain to receive different images, as each eye focuses on its own object. Consequently, fusion becomes impossible, the central nervous system does not perceive the information received, thereby preventing doubling. Instead, information is read from only one eye. Over time, this leads to atrophy of the eye muscles of the eye on which there is no load, which means that vision weakens, amblyopia is diagnosed. Children with strabismus are much more susceptible to this disease than those who do not have problems focusing their eyes on one object.
About terminology
Amblyopia is a term that refers to the situation of the impossibility of the mutual work of the cerebral cortex and the eye retina. With amblyopia, the body simply cannot process information coming from outside in the form of a visual series.
Should I be worried?
Despite stereotypes, amblyopia and strabismus in children is a really big problem that needs to be addressed as soon as possible.intervention. The point is not only damage to the organs of vision, but also mental disorders that occur in sick children much more often. The complexity of vision has a serious impact on the psyche, oppressing the child, preventing him from developing. Mostly children suffering from such difficulties are closed, not self-confident, others are aggressive and look at everything too negatively. Most people with strabismus have an inferiority complex.
The problem is different
It is customary to distinguish three forms:
- false;
- hidden;
- true.
Doctors diagnose strabismus. As a rule, the diagnosis is made at the age of over two, but under three years of age, if by this time the eyes have not begun to function in a coordinated manner. As follows from statistics, reviews, strabismus in children is most often observed during this period. This is due to the specifics of growing up: closer to the age of three, kids become active, study the world around them, and this requires attention and tension of the visual organs.
Babies and older kids
As a rule, there are problems with focusing the eyes of infants. The causes of strabismus in children under one year old are simple - the lack of formation of the visual apparatus, the insufficiency of the analyzer. Until the age of two months, and sometimes twice as much, the eye muscles simply cannot work in harmony. If parents notice strabismus in a child precisely in the first stages of life, it is too early to panic. But if after four months of agethe situation has not improved, so you need to see a doctor.
As a rule, the doctor will answer the question of why a child has strabismus only after conducting preliminary studies. There is a high probability that the cause is congenital. Clarification of the situation is carried out at a planned examination. It is necessary to show the child to the doctor at the age of one month, six months and one year old. Further, the frequency of visits to the ophthalmologist is once a year or twice if no problems are identified. But if, for example, intermittent strabismus is found in children, then visits will have to be more frequent.
Diagnosis
Do not try at home to understand if the child is he althy, what kind of problems he has, if something seems wrong. Only a doctor knows how to determine strabismus in a child, what to do if the diagnosis is confirmed. At the reception, the child will be checked according to a special technique, making a series of tests. The conclusions will allow you to understand exactly what kind of strabismus you had to face - true, false. If eye movement disorders are clearly visible, a pathological condition can be diagnosed.
In practice, very often the suspicion of strabismus occurs in parents whose child has an asymmetrical face. This is nothing more than an imaginary ailment that does not require treatment for strabismus in children. Reviews of doctors about the problems of the visual organs in children contain references to the features of imaginary strabismus. In this state, the analyzers are absolutely functional and operate in accordance with biological standards, and apparent violations are explained either by different eye slits or anatomical features.eyelid devices. From the outside, it looks like one pupil (sometimes both) mows down. Such a problem is aesthetic in nature and does not require specific medical care.
The third form of strabismus is hidden. A feature of the condition is the underdevelopment of the muscle fibers of the organs of vision. When a child studies an object with both eyes at once, it is impossible to see from the side that the pupils work inconsistently. But if you close one eye, the other will start to mow.
Where did the trouble come from?
Before you figure out whether strabismus is treated in children, you should find out what provoked the vision problem in a particular case. There are two options for pathology:
- congenital;
- acquired.
A cross-eyed child may be born due to a genetic factor. Can provoke an ophthalmic problem:
- improper development of the nervous system;
- syndromes of Louis-Bar, Brown.
Often, mothers who have experienced difficult situations that affected the fetus during pregnancy have to figure out how to correct strabismus in a child. Pathological processes received during the birth of trauma, suffocation, hypoxia - all this can provoke the malfunctioning of the visual system.
Factors contributing to the acquisition of strabismus:
- disorders of the nervous system, areas responsible for the coordination of eye movements, due to infection, trauma;
- myopia, farsightedness, dystrophic processes, cataracts and other diseases of the visual organs;
- new growths;
- violation of the integrity of the cerebral cortex, pituitary gland;
- stress, fear, neurosis;
- malfunction of the thyroid gland.
The main task of parents is to protect the child from illnesses, nervous shocks, strong feelings, since all of them can have an unforeseen effect on he alth.
Squint: what happens?
A fairly complex classification system has been adopted, taking into account several features of the problem. Each type requires its own approach to determine what to do. Strabismus in children by the origin of the problem is:
- paralytic;
- friendly.
The first is diagnosed if only one eye is affected, and the limitation is due to the improper functioning of the muscle fibers. In such a situation, complete immobility of the diseased eye is possible. A friendly variant is diagnosed if alternately one or the other eye deviates from the correct visual axis, while the angle is approximately equal. In practice, it is this form that occurs most often, it is with it that worried parents who do not know how to cure strabismus in a child turn to doctors.
Based on how much the visual system suffers from pathology, it is customary to single out cases:
- one-sided;
- intermittent.
The first variant is expressed by strabismus only on one half, in the second case both eyes are involved.
Based on stability casesdivided into: non-permanent strabismus in children, permanent. The second option worries all the time, the condition of the baby or external conditions in no way affect the perception of the world through the organs of vision.
Another type of classification involves taking into account the type of deviation. A mixed form is possible, in which two or three variants of violations are observed simultaneously, or separately:
- vertical strabismus, when the problem is observed along the vertical axis;
- converging, in which the gaze is always directed to the bridge of the nose;
- divergent when the pupils are directed to the temples.
Converging is more often diagnosed in farsighted children, and divergent in nearsighted children.
Finally, the last type of classification takes into account the degree of deviation. Violations that do not exceed an angle of 5 degrees are assessed as minimal, small - up to 10 degrees, medium - twice as much, and high - up to 36 degrees. If the deviation exceeds this limit, the case is rated as very severe.
Concomitant strabismus: features
Within this group of diagnoses, it is accepted to distinguish several subtypes. Only a doctor knows how to determine if a child's strabismus has developed according to which of these three scenarios. Common groups for dividing cases:
- accommodative strabismus;
- partial accommodative;
- not being accommodative.
Accommodative is usually formed at the age close to three years, and the factors stimulating it are othervision problems. Telling how to cure strabismus in a child in this form, the doctor usually recommends choosing the right glasses. This correction method is the simplest and most widely used.
Partial accommodative strabismus usually develops at an early age - from one year old to two years old. To correct the problem, the child is prescribed special lenses. You can achieve a complete cure, but you will have to do an operation.
Strabismus in a child of non-accommodative type can form at any time, there is no link to age. The only method of treatment is surgery. Other therapeutic approaches fail.
As can be seen from the statistics, the treatment of divergent strabismus of a non-permanent type or wandering type is most often required in children. The first option is expressed by the direction of the pupils towards the temples, which is especially noticeable when the child tries to focus on the object of study. However, overall vision is quite good. Wandering strabismus manifests itself as the adequacy of the work of the visual organs separately, while information about objects is read by the analyzer of only one eye, but the second one simply “turns off” at a particular moment.
Going to the doctor: what does it look like?
Only a doctor can say whether it is possible to cure strabismus in a child in a particular case or not, what methods to use, what procedures to go through to achieve a result. True, before dealing with methods for eliminating the problem, you need to confirm the fact of its existence. For this, tests are made to establishfeatures of the functioning of analyzers of the visual system. Doctor conducts:
- examination of the patient;
- assessment of visual acuity;
- perimetry, during which it determines what the fields perceived by the patient are;
- studying the bottom of the eye;
- four-point color test;
- Checking the range of motion of the organs of vision.
Color test allows you to understand whether a child uses one eye or two to see the world around him. While checking the volume, the doctor observes the baby, in front of which the object moves from side to side, up and down.
If there is doubt about the diagnosis, the child is referred for additional instrumental examinations:
- ultrasound;
- tomography.
In some cases, it is necessary to obtain the conclusion of a neurologist, endocrinologist.
What to do?
Only a doctor can tell exactly how to deal with the problem in a particular case. Much depends on the age of the child, the mechanisms that led to strabismus, the specifics of the case, individual indications and contraindications. The main rule is to start therapy immediately, as soon as it was possible to confirm the presence of a vision problem. The trouble will not go away on its own, but the early start of the fight against it will help to quickly defeat the defect with minimal negative consequences.
To determine the appropriate course, the doctor conducts a detailed diagnosis and collects a medical history. In some cases it will be enough to use corrective lenses, in others -to do special exercises, and only surgery for strabismus will help someone. In children, treatment begins, having understood what reasons caused the difficulties in the work of the visual system - it is their elimination that becomes the starting point of the course.
Key approaches
There are two options - surgery and non-surgical treatment. One effective yet safe approach is direct occlusion. The doctor determines which of the eyes is he althy and blocks it for a while. To increase the effectiveness of such influence, therapeutic measures are prescribed to reduce discomfort and weaken the visual defect. The doctor selects a set of exercises for strabismus in children. Indirect occlusion can often help eliminate the need for surgery.
Non-surgical approaches to treating strabismus are most effective when the deviation is estimated to be 10 degrees or less, doctors say. If the situation is worse, the case is severely neglected, do not waste time. This shows an operation for strabismus in children, and all other activities only complement it.
Causes and treatment
Choose a therapeutic approach by evaluating how far progress has been made. If the stage is initial, the use of special drops is usually sufficient. Also, with strabismus, glasses and lenses are prescribed. From two to four times a year, you will have to come to an appointment with an ophthalmologist to check how sharp the vision of a sick child is, how the condition progresses in general.
Also resort to:
- direct occlusion method, temporarily limiting the child's abilitysee with a normally functioning eye (this turns the diseased eye into the dominant one and stimulates improvement);
- hardware treatment, stimulating the retina with pulses of light (laser devices are the most common);
- gymnastics.
Exercises are chosen by the doctor, focusing on individual characteristics. An unsuccessfully selected complex can significantly impair vision. The benefits of gymnastics will only be with regular practice.
Operation Scheduled
Most often, surgery is prescribed if a paralytic form is established. The need for an event dictates a deviation from the axis of vision by 10 degrees or more. First, glasses or lenses are prescribed for the child, gymnastics is prescribed and other approaches are practiced, but if they are ineffective, they decide on the need for cardinal intervention.
If the case is severe, the treatment is two-stage. This is necessary if strabismus simultaneously impairs the function of both eyes. First, they operate on one side, six months later, they perform an operation on the second half. A two-stage intervention is necessary if the deviation from the visual axis exceeds a third of the right angle.
As part of the operation, the main task of the doctor is to change the configuration of the eye muscles, reducing or lengthening them. As practice shows, many parents have a negative attitude to the doctor's proposal to send their child for surgery, fearing that this will only worsen the condition. In fact, there are far more dangers associated with refusing surgery than withsuch an intervention. Modern doctors have access to the latest technologies and equipment, so the activities are carried out with minimal damage to he althy tissues.
Features of surgical techniques
The safest and most effective approach is radio wave surgery. The event does not require incisions, which means that the eye will not be injured, the structure will remain intact. The duration of the rehabilitation period with this method is minimal, as are the restrictions on the activity of the child recovering from the intervention. A minor patient is discharged from the hospital the next day after the event.
It is allowed to perform surgery to eliminate strabismus from the age of four. Occasionally, it is recommended to do the operation earlier - at the age of two to three, but this is possible only with a congenital form. After the intervention, the recovery period begins, associated with conservative methods of treatment.
Don't want to go to the hospital
It so happened that many do not trust medicine too much, preferring to treat any he alth problems at home. You need to understand that no traditional medicine methods will help with strabismus. The only way to defeat a pathological condition is to seek help from a qualified doctor in time and carefully follow his advice. Attempts to cure difficulties with the eyes on their own lead only to the active progress of the condition, the rapid deterioration of the ability to see. It is very difficult to cure a child in such a situation, the probability of irreversible violations is high.
Prevention
You can prevent the development of strabismus if you monitor the child and correct the environment and habits in time. Unfortunately, this will not help prevent the congenital form, but the risk of the acquired form will be significantly reduced. Ground rules:
- do not place static objects near the child's bed, curious for the baby, capable of attracting his attention for a long time;
- installing the crib in an area that can be approached from different sides - this stimulates the interest of the child to consider everything around;
- controlling eye strain when lying in bed, ensuring uniformity;
- preventing contact with TV, tablets, smartphones before three years;
- limiting screen time;
- prohibition of looking at the screen while lying down;
- control of posture when writing, drawing - too low slopes, regular maintenance of a specific tilt of the head significantly increases the risk of a pathological condition;
- choice of children's books with large letters;
- prevention of stress, strong negative experiences.
Prevention is especially significant if among close relatives there are those who have suffered or suffer from strabismus. This fact indicates a predisposition to pathology.
Mindfulness comes first
If a child develops strabismus, do not expect the doctor to offer a magical method to correct the situation in just five minutes. Whatever optionno treatment was chosen, the process will drag on for a long time, will consist of several successive stages, and will lead to success only with careful observance of medical recommendations. On average, as doctors say, the fight against strabismus lasts up to three years, rarely when it is possible to correct the visual system faster than in a year. In many ways, the terms are determined by the timeliness of the visit to the doctor, the adequacy of the chosen treatment program.
As soon as there are signs that allow you to suspect strabismus, you should immediately go to the doctor. It is important to choose a qualified ophthalmologist who can immediately recognize if a child needs help. Only a competent therapeutic approach can guarantee a positive outcome of a comprehensive program.
Should I panic?
If a child's eyes look in different directions, parents, noticing this, can be very frightened. You should not worry beyond measure: of course, this symptom requires an urgent visit to the doctor, but does not mean that the future is put to rest. If you manage to start fighting the problem on time, the probability of a successful solution to it is close to one hundred percent. Modern ophthalmologists have access to effective devices and methods, medicines, which means they can successfully cope with a variety of vision problems. Strabismus will be no exception.
