This article has been provided by Dr. Huseyin ACAR to give information about ‘Cross Eye (Strabismus) in Children and Its Treatment’ in general terms.
HOW DOES OUR VISION SYSTEM WORK?
As we all know, we see the object as one piece although we have two eyes. The reason for this phenomenon is that signals obtained by our two eyes are then transmitted to the visual cortex of our brain converting these signals into one visual piece. In order to obtain the single image, the perceived images should be the same or namely it is required that our eye should be focusing to the same point. Focusing on the same point by our eyes is provided by six muscles around our eyes controlled by our brain. Generally our vision system works as follows: firstly both of our eyes produce separate images. These images are then transmitted into the visual cortexes located at each side of brain floccules. If the transmitted images are the same, our brain converts them into one image. In case that images belong to the different objects, then our brain send signals to the eye muscles to focus on the same point.
Image 1: Focusing on the same point by our eyes is provided by six muscles around our eyes controlled by our brain
WHAT IS STRABISMUS AND WHAT ARE THE CAUSES?
The strabismus happen when our eyes do not focus on the same point but rather focusing on different points. In general the main problem is that the brain cannot control the eye muscles in a required level. Problems may be in cortexes of the brain or in eye muscles or in nerves transmitting signals from the cortexes of the brain towards eye muscles. The eyes may cross into the direction of down or upside and left or right side as per the impacted area. According to the level of impact, strabismus patients can be divided into two categories: those with permanent cross eye and those who have cross eye disorder from time to time.
Image 2: The eyes may cross into the direction of down or upside and left or right side as per the impacted area
WHAT ARE THE SUB TYPES OF CROSS EYE DISORDER IN ADULTS?
It is possible mainly to divide strabismus in adults into two groups. The first one is the group where cross eye becomes permanent disorder after the cross eye occurred from time to time in childhood. Our brain’s power over the eye muscles is higher in childhood ages. Its ability to control decreases as aging gradually and the cross eye occurring time to time may become permanent disorder. As for the second group, illnesses play important roles impacting eye muscles or nerves directing these muscles. For example, some illnesses such as diabetes and hypertension or some situations like head trauma may harm the nerves stimulating the eye muscles or may cause permanent cross eye disorder. Cross eye or strabismus happened in adult ages leads to double vision or diplopia. In order to avoid double vision, the patient tends to close one eye or to turn his or her head towards the direction where double vision is less felt.
HOW TO TREAT CROSS EYE DISORDERS IN ADULTS?
The first thing to be done for the cross eye in adults is to determine the cause of the disorder. Cross eye is corrected usually by surgery for those patients having permanent cross eye transformed from a previous episodic disorder. As for the cross eye disorder which does not have any episodic history previously and occurs recently, the root cause should be investigated. In case that a root cause is found, as a priority this root cause should be treated. For the cases where the root cause was not able to be determined, it is required to observe the patient for a certain period of time and to make sure that cross eye is not automatically recovered, before taking decision on an operation. During this observation period, some methods can be applied to avoid the double vision of the patient.
SUMMARY
Cross eye is the disorder when eyes focus on different points rather than concentrating on the same point. Strabismus observed in adults has two reasons mainly. The first reason is that hidden cross eye existed in childhood ages becomes an obvious disorder. The second reason is because of some illnesses in the brain, in the eye muscles, and in the nerves stimulating these eye muscles. If the root cause is the transformation of hidden cross eye in childhood ages into an obvious disorder, it is usually treated by surgery. However, if the root causes are derived from the illness of our brain, or eye muscles or the nerves stimulating the eye muscles, then it is required to treat the illness of the root cause.