Squinting in case of tiredness – What is behind it?

Temporary strabismus, or latent strabismus, is caused by an imbalance of the eye muscles. In most cases, the child’s brain is able to compensate for this disorder so that the child does not notice any discomfort. If children suffer from severe fatigue, the already existing imbalance of the eye muscles is further intensified.

Due to the additional strain, the brain is at some point no longer able to balance these different impressions. The visual impressions gained by both eyes cannot be processed together and cannot fuse. In these cases, blurred images and headaches occur as a result.

Strabismus is additionally intensified and makes vision even more difficult. In many cases, latent strabismus in small children is often only recognized in such phases with a lot of stress and increased fatigue. Other factors that can accompany an increase in strabismus are lack of concentration, overexertion or psychological stress.

Diagnosis

If a child squints strongly, the unusual direction of gaze is usually noticed by the parents and an examination of the child at the ophthalmologist is necessary. The doctor shines a lamp into the child’s eye during the eye examination. This tests whether the light is reflected back from the same spot on the pupil in both eyes.

If the child is already older, the examination includes more. For example, the child is asked to fix objects with their eyes, sometimes covering one eye. Even slight strabismus can be detected with the results of a thorough eye examination.

Therapy: the earlier, the better

The earlier the therapy of strabismus is started, the better it is for the development of the child. Up to the age of about three years, the development of vision can still be influenced, since the brain is not yet fully developed by that time. First the doctor determines which type of strabismus is present in the individual case.

The visual defect can then often be corrected with glasses. During the course of treatment, the strength of the glasses must be checked again and again, as it is possible that the progressive growth of the child may change it to the positive or negative. It is usually necessary to train the eye weakened by strabismus so that it is not switched off by the brain.

To particularly challenge and encourage the weak eye, the healthy eye is taped at regular intervals. This form of treatment requires a high degree of discipline and patience from both parents and child, but brings very good results. In some cases the strabismus of the child can only be treated by surgery (surgery for strabismus).

The doctor opens the conjunctiva surgically to adjust the eye muscles. In most cases, the conjunctiva heals without any complications. However, three-dimensional vision is often still not possible after an operation.

In most children, strabismus is caused by a longstanding refractive error. Therefore, the ophthalmologist can first measure the severity of the visual defect in the affected children. When determining this defective vision (refraction determination), the deviation of the measured refractive power from the ideal value is determined.This deviation is called a refraction error and is expressed in diopters.

Dioptres are a measure of the existing strength of farsightedness (plus dioptre), nearsightedness (minus dioptre) or curvature of the cornea. In order to compensate for this defective vision in cross-eyed children, glasses or contact lenses are made. They can be adapted directly to the measured values and thus compensate for the deviations in refractive power.

Wearing glasses regularly enables correct and relaxed vision for the eyes. In the course of time the squint angle decreases or even disappears completely due to the decreasing tension. If the difference in refractive power between the healthy eye and the squinting eye is too great, one can also consider covering the healthy eye and the squinting eye with a bandage at alternating intervals.

If the healthy eye is covered, the weaker eye should be trained and the defective vision should be compensated. However, to prevent the healthy eye from losing its vision, the cover must be changed regularly. The use of osteopathy represents an extended possibility within the therapeutic treatment of childhood strabismus.

It is assumed that strabismus can be aggravated by fatigue, tension, stress or psychological tension. In the teaching of osteopathy, defective vision is often seen in connection with existing blockages in the body. Stress, fear and bad experiences are anchored in the muscles of the child’s body.

In cross-eyed children, the muscles on the side towards which the child squints are more tense than on the other side. This can be caused, for example, by a displacement of the cranial bones or an injury during birth. Through targeted massages, loosening and relaxing exercises, the muscle blockages can be released and thus the defective vision improved.