Children’s ophthalmology and strabismus

It’s never too early for an ophthalmic examination, considering that visual development is most intense in very young children. An examination is recommended to detect possible eye misalignment and refractive errors. Although it’s common for eyes to slightly deviate in the first 6 months due to the immaturity of the nervous system, after this period, if the eye continues to turn inward, it may indicate some form of strabismus. Although the actual visual acuity at this age cannot be precisely determined, special equipment tailored to young children, as well as pupil dilation and skiascopy, can help identify refractive errors. If strabismus or a refractive error is diagnosed, it’s possible to prescribe glasses or further therapeutic measures.

In children aged 4 with intermittent strabismus, a comprehensive ophthalmological examination is first necessary to determine the condition. If strabismus is noticed but is corrected with glasses, it’s referred to as accommodative strabismus, where surgery is not necessary as strabismus can be controlled with glasses. If strabismus is not corrected or is not adequately corrected with glasses after several months of monitoring, the option of surgery is considered.

After strabismus surgery, there is a possibility that the eye may again deviate in the same or opposite direction, especially if the operated eye was amblyopic. Reoperation is possible, and the decision depends on the degree of eye deviation and intraoperative findings. Recovery after surgery is fast, and the patient typically stays in the hospital for only one night. It’s necessary to follow the ophthalmologist’s instructions after surgery and avoid physical exertion for several weeks.

In patients with amblyopic eye, surgery can be performed to improve aesthetics, but the expected results may be limited. Additionally, it’s possible that the surgery will need to be repeated due to the increased risk of recurrent strabismus.

In individuals with nerve damage that innervates the eye muscle, such as the abducens nerve, strabismus may be present, and double vision is common. Nerve damage cannot be cured, but symptoms can be alleviated by wearing prism glasses or through surgical intervention. Surgery may help the eye to align straight, which can reduce symptoms, but it won’t completely resolve the problem, especially if there is amblyopia in that eye.

In any case, it’s important to regularly follow the ophthalmologist’s instructions and react promptly to preserve and improve vision and eye function.