Strabismus (Eye Misalignment)

Strabismus, often called a squint or crossed eyes, means the two eyes do not point at the same target. One eye may turn inwards (esotropia), outwards (exotropia), upwards or downwards. The turn can be constant or appear only when you are tired, and it can affect children and adults.

In young children the brain may ignore the turning eye, which leads to amblyopia (lazy eye) and poor depth perception if it is not treated early. In adults a new misalignment typically causes double vision, because the brain can no longer suppress the second image. Treatment can straighten the eyes and often restores comfort, but it does not always bring back full 3D vision.

Symptome

• Eyes that visibly point in different directions
• Double vision, especially in adults with a new squint
• Closing or covering one eye in bright light or to see clearly
• Tilting or turning the head to keep images together
• Eye strain and headaches with reading
• Poor depth perception, clumsiness with stairs or ball games
• In children, reduced vision in one eye found at screening

Ursachen und Risikofaktoren

In children, most strabismus comes from the way the brain controls eye alignment, often with a family history. Uncorrected long-sightedness is a common driver of an inward turn because of the focusing effort involved. Prematurity, cerebral palsy and Down syndrome raise the risk. Rarely, a squint is the first sign of poor vision in one eye from cataract or a tumour such as retinoblastoma. In adults, causes include childhood squint that has decompensated, nerve palsies from diabetes, high blood pressure, head injury or stroke, thyroid eye disease and myasthenia gravis.

Wie es diagnostiziert wird

• Visual acuity and refraction with drops: Measures vision in each eye and the true spectacle need, which in children requires drops that relax focusing.
• Cover test and prism measurement: The orthoptist covers each eye in turn and uses prisms to measure the size of the deviation at distance and near.
• Eye movement examination: Shows whether a particular muscle is weak or restricted, as in a nerve palsy or thyroid eye disease.
• Binocular vision tests: Assess whether the eyes can work together and whether depth perception is present.
• Dilated eye examination: Rules out an eye disease behind the squint, which is essential in every child.
• MRI or blood tests: Arranged for a sudden adult squint when a neurological, thyroid or muscle cause is suspected.

Behandlungsmöglichkeiten

• Glasses: Full correction of long-sightedness can straighten an accommodative inward turn completely in some children.
• Patching or atropine drops: Treats amblyopia by making the brain use the weaker eye. It improves vision, not the alignment itself.
• Prisms: Built into or stuck onto spectacles to join double images in adults with small deviations.
• Botulinum toxin injection: Temporarily weakens an eye muscle. Useful for some nerve palsies and as a trial before surgery.
• Eye muscle surgery: Muscles on the outside of the eye are repositioned or shortened, as a day case under general anaesthetic. Adjustable stitches can fine tune the result in adults. A second operation is needed in a meaningful minority.
• Eye exercises: Help a specific problem called convergence insufficiency; they do not cure most other types.

Wenn es dringend ist

A sudden squint or sudden double vision in an adult or child needs urgent local assessment, especially with headache, a drooping eyelid, an enlarged pupil, weakness, slurred speech or recent head injury. A white reflex in a child's pupil in photographs also needs an urgent eye examination.

Reisen nach Türkiye zur Behandlung

Planned squint surgery is well suited to a short trip: measurements on day one, surgery the next day, and checks over the following week. Bring previous orthoptic measurements and your glasses prescription. Amblyopia treatment in a young child is different: it involves months of patching with repeated checks and belongs with a local eye team. Be realistic that an adjustment or further surgery may be advised later.

Senden Sie Ihre Berichte, Scans und eine kurze Geschichte und eine Clinic-Y Koordinator Antworten innerhalb von 24 Stunden mit geeigneten Teams und schriftlich, All-inclusive Vorschläge nebeneinander. Die Überprüfung Ihres Falls ist kostenlos.

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