Treatment of children’s strabismus
The ophthalmologist’s job is to understand what type of strabismus the patient has and to choose suitable treatment methods. Consequently, the doctor has to be very skilled and to have a vast clinical experience. Our ophthalmologists treat both simple and complicated cases of children’s strabismus.
Methods of children’s strabismus treatment
Treatment of children’s strabismus is quite a challenging task. Ophthalmologists often undergo special study to be able to diagnose its type and to choose applicable treatment methods. Some of these methods are described below.
Concomitant strabismus is treated with spectacles and occlusion (a plaster is glued onto a child’s healthy eye for several months). Besides, visual acuity of the healthy eye is always monitored.
A device is used that irritates the retina with light rays to improve visual acuity. The patient performs special exercises to develop binocular vision.
Medications are used to stimulate the work of the eye and to increase load on it. They can relax muscles, dull vision and prevent pupil contraction.
Surgical treatment makes it possible to strengthen or weaken oculomotor muscles in order to decrease the strabismus angle. Usually, operations are used for paralytic strabismus. There are two types of surgery. During recession the doctor moves the muscle back or forward and respectively weakens or strengthens it. During resection the doctor strengthens the muscle by removing a part of it. This is a plastic surgery which is performed under local anesthesia and which does not require long hospitalization. The patient usually stays at the hospital from several hours to one day. Several operations can be done, the break between them should not be less than six months. Even in case of apparent strabismus, surgery is rarely performed at children younger than 3-4 years of age. The operation is always complemented by other treatment types.
If the paralytic strabismus is significant, and the operation is not indicated (for example, for a child under 3 years old or immediately after paralysis), chemodenervation is performed. Botulinum toxin (Botox) is injected into the oculomotor muscle. It relaxes the muscle, the spasm of which keeps the pupils in an asymmetrical position, and as a result the angle of strabismus is significantly reduced. Surgery can be performed some time after chemodenervation.
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