If you notice that your child looks differently with one eye than the other, don't panic and see an ophthalmologist. Strabismus can be eliminated. However, treatment must be started early. Yawning can happen to any toddler because their eye muscles are not yet sufficiently developed and sometimes they fail to keep their eyes in the correct position.
Even a six-month-oldchildin moments of high emotions or distraction, the eyes may "run away". But a six-month-old child should look straight ahead and follow the toy with his eyes. Wheneyesare constantly pointing towards the temples ( squintdivergent) or towards the nose (converging) or in different directions ( alternating), do not count any more that he will grow out of it, just go to an ophthalmologist as soon as possible. Also, do not underestimate the "escaping" of one or both eyes of a six-month-old toddler.
ZEZ - why this defect?
It is not known exactly why some children squint and others do not. But when either parent or grandparent has had strabismus, the chances are high that the child will inherit it. However, a toddler can also have strabismus without any genetic burden. Usually, it is the result of unequal development of the eye muscles. To each eye are symmetrically attached two pairs of straight muscles (at 3 and 9 o'clock as well as 12 and 6 o'clock), which are responsible for moving the eye sideways and up and down, as well as two oblique muscles, thanks to which the eye performs circular movements. If the muscles responsible for each movement work synchronously, the two knobs move in different directions in unison. But if one of the muscles has not developed properly (e.g. it is too short), then the vision axes of both eyes are not parallel to each other.
ImportantBaby glasses
If, in addition to strabismus, the child is diagnosed with myopia or hyperopia, he will have to wear glasses. Choose him glasses that are light and shatterproof. Ideally, they should be made of hardened, shatter-free plastic. They should have soft frames, rounded temples and a special nose protector. At first, the toddler will take off the glasses and treat them like a toy, so they must be such that he does not hurt himself. Your child will quickly get used to the glasses as they will realize that they can see better through them. Even two-year-olds are prescribed glasses.
Wheneye squinting
Lack of coordinated eye movements prevents correct binocular vision. Why is this happening? With proper vision with both eyes, the same images appear on the retinas, which overlap on the way to the brain (each point of one eye's retina corresponds to a corresponding point on the other's retina - this correspondence is the basis of depth vision) and are perceived by the cells brain as an image of what we are looking at. On the other hand, when the eye squints, both eyeballs send images to the brain that do not overlap. In addition, the image in the squinting eye is created outside the macula (the place responsible for seeing colors and details, so it enables, for example, reading), therefore the toddler sees with this eye "as if in a fog". After all, the brain ignores the visual information sent by the weaker eye. It only receives the image transmitted by the eye that can see well. The weaker, on the other hand, is excluded from performing their functions, despite the fact that it is built correctly, and if it were not for strabismus, it would see well.
ImportantHow children have their eyesight tested
Strabismus is often accompanied by a visual impairment. To help a child, the ophthalmologist must first find out the cause of the problem and assess the size of the strabismus. Then he will be able to choose the therapy. For young children, a visual impairment is determined by means of a sciascopy. The ophthalmologist also shows the toddler pictures or objects of various sizes and observes how he reacts to them. After atropine has been instilled into the eye, the doctor checks the child for visual impairment. Short-sighted people usually tend to divergent squint, while long-sighted ones - to convergent squint.
Strabismus correction
The ophthalmologist must first examine the child's eyesight to choose the best method of squint correction. The choice of therapy depends on the type and size of the defect. The doctor may recommend covering the eye that sees better, so that the squinting - weaker and more "lazy" eye - can be forced to work harder. Sometimes, instead of covering the eye, atropine is instilled to make the "good" eye see worse. Atropine only worsens the vision at close range, while at a distance the child sees the same way, but is more dazzled by light. And because the smaller the child, the less he has to see around him (mainly toys and mom), it works especially for toddlers. But there is no rule. At the same time, exercises are used (e.g. finger tracking) to strengthen the muscles. The doctor selects exercises individually depending on which muscles are not working properly. Treatment must last at least several months. But if the strabismus is small (deviation up to 10 degrees), such therapy brings good results. If with glasses andexercises will not be able to eliminate the squint, then a surgical correction is necessary.
You must do itStrabismus must be removed during the development of the eyeball, i.e. before the child turns 6 years old. The sooner this is done, the sooner the child can see properly. Removing the defect after the age of 10 is very difficult. If the defect requires the intervention of a surgeon, do not delay the decision. Out of concern for the baby, we often postpone the surgery until the baby grows up. Unfortunately, we unknowingly reduce his chances of seeing normally. It is best to perform the operation when the child is 4 years old. However, in the case of large convergent strabismus, the procedure is already performed on two-year-olds, because such a defect may result in a rapid loss of vision.
Don't be afraid of squint surgery
This is a harmless procedure. Although it is not painful, it is performed for children under general anesthesia. By crying and struggling, they would have made surgery impossible. Most often it is performed around the age of 4. The child is large enough to work with an ophthalmologist during eye examinations, and small enough to restore normal vision. It is important to know that surgery for strabismus in adults is only aesthetic and does not improve the quality of vision. This is because the squinting eye is already permanently disabled by the brain from seeing, and it cannot be reversed even when the eyes are aligned in parallel. Moreover, in order for the eyes to remain in a parallel position, they need to see correctly, and because they are not, the squint returns after a few months. The procedure takes about an hour. Parents should be reassured by the information that it is performed on the muscles attached to the eye, without interfering with the inside of the eyeball. It consists in weakening the muscle that pulls the eye too much in one direction (e.g. by shortening it and sewing it elsewhere), and strengthening the muscle that is too weak (e.g. by shortening and sewing it in the same place, thus reducing the strength actions). The eye is not covered after the operation. The toddler must move it immediately so that it does not form adhesions. The eyes are already positioned parallel, but they still need to be taught to see properly, that is, to make the path of the visual impulses to the brain. For this purpose, for 1-2 weeks after the operation, the ophthalmologist selects exercises that need to be performed for up to a year. If your toddler has a visual impairment (e.g. is nearsighted or farsighted), he will have to wear corrective lenses.