Strabismus In Adults - What Is It? First Symptoms, Causes And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

What to do if you suspect squint?

Strabismus can develop not only in children, but also in adults. This pathology can also be found under the name strabismus or heterotropy.

In people with strabismus, the eyes cannot be focused in one direction, therefore, the sicker is not able to direct both organs of vision at once to one object. One eye will be diverted to one side, up or down. For some people, strabismus is temporary and only occurs due to illness or stress. Others have it on an ongoing basis.

If you do not start treatment on time, then strabismus will cause a decrease in vision. This problem develops in 5% of patients with heterotropy.

Content:

• What it is?
• Causes of strabismus in adults
• Classification
• Symptoms of strabismus in adults
• Diagnostics
• Treatment of strabismus in adults
• Complications
• Prevention

What it is?

Strabismus is a disorder in which the visual axis of the eye is disturbed. The gaze cannot be focused on one point, so a person perceives the same object in different ways.

The brain receives the wrong signal and processes it in the same way. To protect itself, the central nervous system excludes the diseased eye from its "zone of responsibility." Therefore, it is wrong to consider strabismus exclusively as a defect in appearance. This is a serious medical condition that needs treatment.

Problems it can lead to:

• The inability to correctly assess the size and distance to the object.
• Impaired perspective perception.
• Deterioration in coordination. If it develops in a child, then it will be difficult for him to maintain balance, he will often fall. Small children with strabismus may refuse to stand up at all.
• Decreased vision, incorrect processing of the information received from the visual analyzer by the brain.

If a person's squint is insignificant, then it is most often discovered by accident. Dealing with such a violation is not difficult. With severe strabismus, treatment is not always effective.

Adults rarely see an ophthalmologist. Even if their eyesight begins to deteriorate, they attribute it to the natural aging of the body and are in no hurry to solve the problem. You should not do this. It is important to see a doctor on time. The earlier the treatment of strabismus is started, the more favorable the prognosis.

Causes of strabismus in adults

Strabismus can be congenital or acquired. Moving squint is also distinguished.

The reasons that cause acquired squint are the following:

• Optic nerve atrophy.
• Cataract.
• Belmo.
• Degenerative processes of the macula.
• Retinal detachment.
• TBI leading to paralysis of the cranial nerves.
• Benign and malignant tumors.
• Infection with viruses and bacteria, leading to the development of neuroinfection. Strabismus can occur with meningitis and encephalitis.
• Stroke.
• Violation of the integrity of the bottom or wall of the orbit.
• Multiple sclerosis.
• Myasthenia gravis.
• Complications of diseases of the respiratory system.

Congenital strabismus can occur for the following reasons:

• Intrauterine developmental disorders.
• Genetic abnormalities.
• Early onset of labor.
• Cerebral palsy in a child.
• Dropsy of the brain.
• Congenital cataract.

Classification

There are several classifications of strabismus, each of which is based on a specific criterion.

Depending on the time of development, violations are distinguished:

• Congenital strabismus. It is diagnosed in a child while still in the maternity hospital. Doctors call this pathology infantile heterotropy. It is rarely diagnosed.
• Acquired squint. A disorder develops due to an infection, after serious illness, against the background of an injury with damage to the spinal cord or brain.

Depending on the frequency of strabismus manifestation, there are 2 forms of it:

• Temporary.
• Constant.

Depending on the involvement of the organs of vision in the pathological process, strabismus can be:

• One-sided.
• Alternating.

Depending on the severity of the violation, there are:

• Latent squint. It will be possible to diagnose it only in the ophthalmologist's office using special equipment.
• Compensated strabismus. It can be detected only after special tests.
• Subcompensated strabismus. The person can partially control the squinting eye.
• Decompensated strabismus. The movements of the eyeball are out of control.

Depending on the cause of the occurrence, there are such types of violations as:

• Concomitant squint. Such a violation is most often diagnosed in childhood. The eyeball is displaced from time to time, or strabismus is present on an ongoing basis. Most often he squints his eye towards the bridge of the nose.
• Paralytic strabismus. It develops mainly in old age. The cause is disturbances in the work of the oculomotor muscles.
• Periodic strabismus.

Depending on the direction of the eyeball, such types of strabismus are distinguished as:

• Esotropia. In this type of strabismus, the pupil is located closer to the bridge of the nose (convergent strabismus).
• Hypertropia. The patient's pupil goes up, can roll under the eyelid (upper vertical squint).
• Exotropy. The human pupil tends to the bridge of the nose. This is the so-called divergent squint.
• Hypotropia. In this type of disorder, the pupil rolls up under the lower eyelid (vertical lower strabismus).

Depending on the mechanism of development of the disorder, there are 3 forms of strabismus:

• Accommodative strabismus, which is divided into refractive and non-refractive. With refractive strabismus, the patient develops severe ametropia. Treatment for accommodative strabismus involves wearing glasses.
• Non-accommodating strabismus. The person has abnormal refraction and ametropia. The severity of the disorder varies widely. It will not be possible to get rid of pathology with glasses. Non-accommodating strabismus develops due to unsuccessful surgical intervention on the organs of vision, in the presence of a corneal leucorrhoea, with pathologies of the optic nerve, or with congenital cataracts.
• Partially accommodative strabismus. It is possible to cope with the disorder with the help of corrective glasses, but the doctor will not guarantee the patient a complete restoration of vision.

Symptoms of strabismus in adults

Most often, the symptoms of strabismus are obvious even for people who have no medical education.

Among them are:

• Dizziness attacks that occur unexpectedly for a person.
• Double image in the eyes.
• Difficulty perceiving objects in the distance.
• Difficulty reading text and writing.

Doubling in gases with strabismus occurs only in adults, since children's eyes compensate for this symptom on their own.

The symptomatology of strabismus is influenced by the form of the disorder.

If the patient develops a friendly squint, then his symptoms will be as follows:

• Displacement of one organ of vision to the side.
• Alternating eye displacement to the side.
• The presence of the same angle of displacement in both eyes.
• Excessive mobility of the eyeball. The direction for movement can be different.
• Impossibility to render volumetric and comparative images.
• Deterioration of visual acuity in the diseased eye.
• Violation of the refractive function of the eye.

Symptoms that characterize paralytic strabismus:

• Deterioration of the natural mobility of the eyeball.
• Various angles of deflection.
• Lack of binocular vision.
• Doubling in the eyes.
• Dizziness.
• The head will be involuntarily turned towards the affected eye.
• Constant squinting.

Diagnostics

With severe strabismus, there are no problems with its diagnosis. The doctor must not only establish the presence of a violation, but also determine the degree of its development. The doctor should be able to recognize pathology when it just started to form.

To make the correct diagnosis, research methods such as:

• Assessment of visual acuity.
• Inspection on the synoptophore. The physician is able to assess the ability of the eyes to fusion images.
• Computer refractometry. This test evaluates the refraction of the patient's eye.
• Ophthalmoscopy and biomicroscopy. The doctor examines the fundus of the patient and the condition of the retina.
• Tests to determine if a patient has binocular vision.

Patients with strabismus may require consultation with a neurologist. It is shown to all patients with such forms of heterotropy as: alternating, paralytic, divergent.

Additional diagnostic criteria include:

• Determination of the angle of divergence of the pupils.
• Revealing latent strabismus.
• Identification of other disorders of the eye.

Patients with strabismus and thyroid disorders require consultation with an endocrinologist. To cope with the problem, highly specialized treatment is required.

Treatment of strabismus in adults

The main tasks that need to be solved when undergoing strabismus treatment:

• Correction of disturbed visual axes.
• Strengthening the eye muscles.
• Restoration of synchronous operation of the eyeballs.
• Avoiding visual impairment.

Treatment of strabismus in adult patients is a lengthy process. For the rest of his life, he will need to make efforts to prevent strabismus.

Methods for treating strabismus in adults:

• Correction of vision using an optical system.
• Hardware treatment.
• Pleopto-orthopedic therapy.
• Formation of binocular vision.
• Operative intervention.

Optical correction

Regardless of the form of strabismus, wearing glasses will not do harm. Correctly selected optics allows you to normalize refraction, get rid of accommodation spasm, and improve the functioning of the organs of vision in general.

Hardware treatment

Apparatus treatment is indicated for all patients in whom strabismus leads to decreased vision. Such therapy allows you to suppress the activity of a healthy eye and stimulate the functioning of the affected organ.

Hardware procedures that can be prescribed for patients with strabismus:

• Pleoptics. A healthy eye is simply "turned off" for a while. Therefore, a person will be forced to look only with a squinting eye. During treatment, the central dimple of the retina of the affected organ is stimulated. A beam of light or a laser beam acts as an irritant. They also carry out reflexology and electrical stimulation of the eyeball.
• Orthopedics. Immediately it is necessary to make a reservation that such treatment has little effect on adult patients. Therapy involves working with game computer programs that train the organs of vision. This also includes performing exercises on a synoptophore (a special ophthalmological apparatus).
• Diploptics. This is a system of therapeutic measures that involves performing specialized exercises, using a reading grid and visual field dividers. Exercises can be performed on special stereoscopic devices.

Exercises for strabismus

If a person performs the exercises regularly and to the fullest, then the result will not be long in coming. It is often possible to cope with strabismus completely. Recommended exercises:

• A person should stand with his back to the light. A healthy eye is covered with a palm. The head must be turned until the sun beam hits the squinting eye. You need to complete the exercise 10 times.
• The head needs to be brought back and from this position they try to make out the tip of the nose.
• Hands are extended forward and touch the tip of the nose with the fingers. During the exercise, you need to concentrate your gaze on the index finger, without interrupting its movements. You need to perform the exercise until your eyes begin to water.
• You will need to take a pointer and drive it in different directions. The eyes need to keep an eye on its tip.
• The palms are pressed to the eyes and in this position they mentally draw outlines of various geometric shapes.

Surgical treatment of strabismus

If it is not possible to cope with strabismus with the help of exercises, glasses and hardware treatment, the patient is operated on. It is aimed at correcting the balance of the muscles of the eyeball. Such treatment allows you to cope with the violation. To increase muscle activity, either resection or excision is performed. If muscle tension is required, the doctor performs a recession.

Surgery is always used to treat patients with atypical strabismus. Even if it cannot correct vision with its help, the surgeon will be able to eliminate the cosmetic defect.

Modern surgical care for strabismus elimination:

• Resection. It aims to shorten the eye muscle. For this, the doctor carves out a part of it.
• Recession. The muscle is displaced forward or backward. After giving it an optimal position, the doctor hangs it up.

Only a specialist can decide on the method of surgical intervention.

Complications

The main complication of strabismus is blindness. Also, patients experience a violation of binocular vision due to which they are unable to see three-dimensional pictures. Complete loss of vision develops with severe pathology and no treatment.

Prevention

In order to prevent the development of strabismus, it is recommended to regularly visit an ophthalmologist, observe the hygiene of vision. The eyes must be treated with care. All ophthalmic infections must be treated promptly. The same applies to neurological pathologies and somatic diseases.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".