Therapy
Strabismus must be treated in order to prevent the most serious complication, namely weakness of vision. However, it is not only the strabismus of the eye that needs to be corrected, because this alone is unfortunately not enough. The weaker eye must also be trained in its plasticity during therapy.
It must be encouraged to engage in and train its vision just like its healthy partner eye. It is important here that the therapy takes place as early as possible, since the human eye develops its plasticity between the 1st and 5th year of life. As explained above, the first step in the therapy of strabismus is the treatment of weak vision, only then should the strabismus operation be performed.
Without treatment by an ophthalmologist, strabismus will not improve and permanent damage will occur. Basically 3 principles of therapy apply:
- Possible compensation with glasses
- Covering an eye with an occlusion patch
- Squint surgery
1. compensation with glasses In case of a possible long-sightedness, it is possible to try to compensate the deficit of accommodation with glasses. Accommodation is the ability of the lens of the eye to deflect and flatten itself in order to focus on objects at different distances.
So it is possible that the child squints because one eye is farsighted and therefore uses only one eye to fixate on the object, which can produce a sharp image. 2 . Occlusion treatment By masking the better eye, the weak eye is “forced” to undergo vision training.
The weak eye has to be trained to make both eyes see equally. This way the child will look with both eyes. The eye can either be taped over with a plaster or merely covered with glasses.
In the case of plaster occlusion of one eye, the duration of the treatment must be taken into account. One eye, even the better one, must not be covered for too long – just a few days in a row. If the better eye is to be prevented from seeing by means of glasses, the lens is covered on this side.
In most cases, this is the worse method because children look beyond the edge of the glasses or even do not wear them. 3. surgical treatment After the occlusion treatment, the operation is performed. As a rule, it should be performed at preschool age.
If the patient has a forced head position or a very large squint angle, the operation can be performed earlier. If possible, two eye muscles are operated on. One must imagine that one muscle is too short, another too long.
Strabismus is always performed in the direction of the short muscle. The attachment of the muscle that is too short to the eye is separated and moved back so that the eye can move further towards the center. The muscle on the opposite side is shortened. As a final result, the eye is in the middle and looks straight ahead.
