Eye Care Eye Care Basics

Lazy Eye

When eyes are misaligned or are not looking at the same place at the same time, it is a condition called strabismus, commonly referred to as 'lazy eye.' The name is derived from the Greek word, 'strabismos', which means to squint. Many patients with strabismus will squint on occasion, especially in bright light outdoors.

Types of Strabismus
Many people think that strabismus is the result of an eye muscle problem, but in most instances, the eye muscles are quite healthy. Most of the time, the problem lies in the part of the brain that controls fusion, or keeping both eyes simultaneously directed toward the object of interest. Some forms of strabismus are the result of abnormally functioning eye muscles, or nerves that stimulate an eye muscle; this is known as paralytic strabismus because a muscle is believed to be paralyzed. There are also medical conditions that can cause an eye muscle to be too tight or restricted, causing restrictive strabismus. If an eye is crossed inward toward the nose, esotropia exists. If an eye is turned toward the ear, it is called exotropia. If an eye is turned upward or downward, a hypertropia or hypotropia, respectively, exists.

Who Gets Strabismus?
In the preschool age group, three to five percent of children have some form of strabismus. The genetics or inheritance pattern of it is very complex and not completely understood. Overall, about 30 percent of patients with strabismus will have a close family relative who has some form of strabismus too. In most cases, however, there is no known relative with it.

Certain groups of patients have a higher incidence, including children born prematurely, those who had retinopathy of prematurity (a potentially blinding condition of premature infants that affects the retina in the back of the eyes), children who are developmentally delayed, children with a family history of strabismus, and those with craniofacial (skull shape) abnormalities, just to name a few.

Adults can also develop strabismus, as the result of a medical or neurological problem that developed in adulthood or it can be a recurrence of childhood strabismus. It can also develop following certain forms of head trauma in both children and adults.

Treatment
There are several reasons why strabismus needs to be treated. For one, it does not improve by itself. It is a myth that children usually outgrow the problem.

Second, young children with it have a significant chance of permanently losing vision in one eye-a vision loss that is not recoverable with eyeglasses. If a child does not develop the ability to use both eyes together as a young child, this ability will not develop later in life. Some people whose eyes are visibly misaligned have difficulty communicating with others, and some may have difficulty with self-esteem.

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