Strabismus is used to describe misalignment of the eyes. It is a common condition in which the eyes fail to work in tandem to track or focus on an object correctly. With strabismus, instead of both eyes focusing ahead, one of the eyes tends turn in, out, up, or down (the brain typically ignores visual input from the turned eye). Although it is mostly associated with children, it can also occur in adults.
Causes of Adult Strabismus
Abnormality in the nerves or muscles associated with eye movement and their connection to the brain can cause strabismus to occur although the clear cause of strabismus is not yet known. Contributing factors to adult strabismus include:
- Recurrence of childhood strabismus
- Uncorrected childhood strabismus
- Thyroid eye diseases
- Certain neurological conditions
Symptoms of Adult Strabismus
The classic indicator of strabismus is the visible turning of the eye. Other symptoms for adult strabismus include:
- Visual confusion: This is seeing two different images imposed on each other.
- Diplopia or Double vision: Seeing two images of the same thing instead of one.
- Image jump: This is when the field of view of the image captured changes significantly as focus shifts between one eye and the other.
- Abnormal head posture: Adults with strabismus often find themselves tilting their head to compensate for the double vision. Over time this can result in the neck muscles shortened and tightened changing the person’s head range of motion or posture.
Diagnosis of Adult Strabismus
Although the symptoms of adult strabismus are quite prevalent, a complete physical examination by an ophthalmologist is still needed to diagnose the condition.
Treatment for Adult Strabismus
There are different types of treatment for adult strabismus depending on its cause and severity and they include:
- Orthoptics (eye exercises)
- Use of prism in eyeglasses to correct double vision
- Injections of botulinum toxin
Surgery for Adult Strabismus
The goal of surgery for adult strabismus is to improve the alignment of the eyes, eliminate double vision, and improve an abnormal position or the head. Adult strabismus eye surgery involves moving or tightening one or more of the outside eye muscles which move the eye.
There are two types of adult strabismus surgery and they are adjustable and non-adjustable.
This procedure is done under general anesthesia and it usually takes about an hour depending on the number of muscles that require surgery.
Certain types of adult strabismus can have better results when treated with adjustable suture. These include patients who have adult strabismus due to thyroid eye problems or injury and those who’ve had strabismus surgery before.
The main operation is carried out under general anesthesia. Once the main operation is done and the patient has woken up the final adjustment is done. It involves putting a few drops of anesthesia into the eye to numb it and adjusting the final position of the muscles. The reason why it is done when the patient is awake is because the patient is able to look at a target. During the procedure the patient can experience some slight pressure in the eye.
This type of surgery is mostly used to treat double vision.
After the operation you will receive post-op instructions such as:
- Using prescribed eye drops
- Use of painkillers
- Clean the stickiness of the eyes using cooled boiled water and cotton wool
- Avoid water from entering the eyes for the first two weeks
- Do not rub the eyes
- Avoid contact lens wear until you’re cleared by your doctor
- Avoid swimming for 4 weeks
- Continue using glasses if you had them
- Attend post-op clinic appointments
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