14 types of strabismus and vision screening for Children

There is nothing more important and more beautiful in the human body than the eye and no one can do without it. Allah has gifted humans with the eye to perceive the world around them and to create their own future. Though, there are some diseases that concern people and make them fear for the safety of this essential sense, one of these diseases is the Strabismus (Squint).

According to Dr. Walid Mohamed Abdalla, Consultant Ophthalmologist, Fellow of Royal College of Surgeons, Glasgow, UK, Fellow of Bascom Palmer Eye Institute, Miami, USA, Fellow of Limoges University, France, and Fellow of International Council of Ophthalmology, strabismus is one of the specialties that directly connect with children as they benefit from its treatment in saving their eyesight. Strabismus treatment is not only oculoplastic procedure; it saves children from many vision problems in the future.

Dr. Walid Abdalla stated that there are more than 14 types of strabismus; including congenital strabismus, for which a rapid and early treatment is recommended and preferred at early age. People should not wait for the child to grow up so that they start the treatment process of congenital strabismus. There are types of strabismus that appear in the first 3 or 4 years of the child’s life. These types are not congenital, they appear due to an impairment in the child’s eyesight and vision, whether due to poor eyesight or hyperopia (long sightedness). Treatment of this type is by correcting the vision impairment, then correcting the sight, either by eyeglasses, and if the eyeglasses does not correct it, strabismus is treated by eye surgery. There is also strabismus that affects the elderly. In young people, strabismus happens due to poor vision or saccadic dysfunction. There are internal and external or horizontal and vertical strabismus. People are more concerned with the causes than the effects. They believe that all types of strabismus are congenital, though there are only two types of congenital strabismus and the rest happen due to health reasons related to the eye. There are types of strabismus caused due to injuries resulting from accidents or falling. These types of strabismus are treated by surgical intervention.

Dr. Walid Abdalla added that all types of strabismus can be treated, but there are types of strabismus that a person neglects so their treatment becomes more difficult, making it impossible for the sight to be normal, but it is possible for the shape of the eye to be corrected after surgical intervention, that’s why we recommend parents to treat strabismus in children as at early age the treatment is 100% effective and successful, whether the impairment is in the shape, vision or function, meaning that the two eyes will have aligned movement. Eyes of persons with strabismus turn in two different directions as they don’t line up with one another, causing poor vision. For example, a strabismus patient cannot watch 3D movies and the quality of his vision decreases. Here, we mean the vision of the lines and squares, where they start and where they end, and their shapes. Patients with strabismus suffer from distorted vision. When they get through a door, they may not be able to perceive it, making them hitting the wall instead. All of these functions are impaired for strabismus patient.

We are fighting the idea of treating strabismus at a certain age. There is no standard age for treating strabismus. For example, patients with intermittent strabismus are mainly given time until the intermittent strabismus is firstly controlled, whether by eyeglasses or exercises, in order for the strabismus to be controlled without intervention. If the eyeglasses or exercises cannot correct the intermittent strabismus, there must be a surgical intervention. if the patient is a 6-year old child suffering from constant strabismus and we cannot control it and it is not predicted to be controlled, there will be a necessity of surgical intervention at this young age.

There are several symptoms of strabismus and a mother can recognize them easily; for example, the eyes don’t look in the same direction at the same time. Another case is when the right eye drifts towards the ear, the left eye drifts towards the nose or towards the ear, or deviates down and up. It is not necessary for strabismus to be apparent all the time. If it happens once or twice, it is an intermittent strabismus. When the strabismus happens at first, it is usually intermittent, even in adults, then a patient starts to lose control of his/ her eyes. After that, the angle of strabismus starts to increase or decrease, and based on that we decide whether such intermittent strabismus is increasing, decreasing, is easy to be controlled, or requires surgical intervention. If the case gets worse, there must be surgical intervention. so each case is dealt with separately.

Strabismus is part of pediatric ophthalmology. Eyes need to be checked up periodically, especially in the period from 6 months to 3 years so that we can find out any invisible congenital defects or discover if there is a vision defect, for example, there might be one eye different from the other or one eye has less vision than the other, resulting in eye laziness, which causes suffering in the future and results in strabismus. Children do not feel these types of strabismus and cannot express them. Therefore, we recommend parents to visit the ophthalmologist for eye examination once for their children aged 6 months to 3 years. This will save them from any problems resulting from these defects and it does not cost much. There is a universal call for getting eye examination for children before the age of nursery or 4 years.