Therapy

In order to maintain binocular vision in normosensory late strabismus, a prompt operation is advisable. It is recommended to have the operation after 6 months at the latest. The goal is to restore the parallel eye position in order to make binocular vision completely possible.

In early childhood strabismus, first of all the visual abilities, binocular vision and spatial vision are conservatively promoted. An operation is often recommended at preschool age. In preliminary examinations, the ophthalmologist performs various measurements of the squint angle, tests of the eye’s mobility and tests of the ability of binocular vision.

It is analyzed exactly which eye needs surgery and to what extent the eye muscles need to be changed. Before the surgery, appropriate information about the operation and the anesthesia should be given by a doctor and an anesthesiologist. This also includes information about prescriptive measures that should be followed and limits and possibilities of the operation.

In children, the operation is usually performed under general anesthesia. In adults, however, local anesthesia is usually sufficient. The operation includes the correction of the affected eye muscles.

Usually two eye muscles are changed at a time. As in other parts of the body, there are always so-called pairs of muscles on the eye that perform the opposite movement. This means that one eye muscle is responsible for the eye looking to the left, while the so-called antagonist muscle ensures that the eye can look to the right.

The goal is to create a balance of the eye muscles and thus to adjust both eyes parallel again. One speaks here of a combined squint operation. First the conjunctiva of the eye is opened to reach the eye muscles.

Afterwards the insertion of one muscle is shifted back while the opposite muscle of the same eye is shortened. Only the outer eye is operated on. The interior of the eye remains untouched.

Regular check-ups are performed after the operation. The eye is often slightly reddened after the operation and can cause itching. In rare cases, double vision may occur, but this will recede after a few days.

In case of uncertainty, the doctor should be consulted. After a strabismus operation, the patient is usually put on sick leave for 2 weeks. Bathing, swimming and sauna should be avoided for at least one week.

To support the healing process the doctor usually prescribes eye drops and an eye ointment. Strabismus surgery only affects the outer eye. Therefore it is usually low-risk.

Inflammations and post-operative bleeding can rarely occur. In some cases, strabismus is under- or over-corrected, so that double images, for example, may still be present. Only under certain circumstances, in very rare cases, complications can endanger visual abilities and eyesight.

Depending on the type of strabismus, it is possible to correct the strabismus itself through a so-called fusion training. Special visual exercises are repeated regularly. These exercises are designed to train the eyes to be able to merge the images of both eyes into one image.

This training can be successful with slight latent strabismus. In cases of pronounced strabismus and manifest strabismus, the training is not sufficient to correct the strabismus. Another training option for slight latent strabismus is the so-called occlusion therapy.

Here, the healthy eye and the strabismus are alternately masked for a while.In some cases it is also possible to mask the respective lens. This forces the squinting eye to see. This method is used especially for children. The chances of success depend on the squint shape and individual influences.