Strabism surgery

In everyday language, to be affected by strabismus means being “cross-eyed” – An affliction where the visual axis of each eye is not aligned on the same subject. Simply put, one eye looks at the intended target while the other looks away. The eyes may be non-aligned inwards (esotropia), outwards (exotropia), upwards (hypertropia) or downwards (hypotropia).

Constant strabismus
Strabismus can be constant or intermittent. In the latter, the eyes squint at certain times of day or evening, sometimes induced by fatigue.

Who suffers from this affliction?
Strabismus can affect both babies at birth and older children. The causes are many and varied hence too numerous to be listed here.

Why correct a squint?
In adults, strabismus causes double vision (diplopia), in children, it can be different. Often, the child will choose an eye that becomes the one that never squints, while the vision of the "crossed" eye is gradually left out by the brain to prevent double vision. Over time, amblyopia will set in this eye. Moreover, as three dimensional vision requires simultaneous use of both eyes, it will not develop properly. Sometimes strabismus occurs because an abnormal head position, for example when tilting the head towards the right shoulder, which can cause muscle problems in the neck.

This is why strabismus correction should be done as early as possible, as the child's vision develops.

How do we correct strabismus?
The type of treatment used to correct strabismus obviously varies depending on the cause. In some cases, correction can simply be achieved by wearing glasses. Surgery has to be performed if glasses do not correct the entire deviation. Let us note however that surgery cannot be substituted for the use of glasses.

Orthoptic treatments are another way to correct strabismus. The orthoptist's job involves screening, ensuring the recovery and rehabilitation as well as the functional exploration of vision problems. This medical professional can work with infants, children, adults and the elderly.

When a patient comes in with a vision problem, the orthoptist is there to advise the patient on their optimal office setup, lighting, eye-to-screen distance, in order to foster the best use of the patient's visual capabilities.

In cases of low vision following a specific rehabilitation, the orthoptist provides the patient with a tailored training program to educate them on the proper use of optical aids.

Orthoptists work on medical prescription, thus with physicians. They practice their work in association with paramedical professionals and opticians responsible for the optical equipment.

For other types of strabismus, treatment is usually surgical. The procedure involves a retraction or shortening of some of the muscles attached to the eyeball in order to restore the alignment. It should be noted this type of surgery can be performed on both eyes or even on the contralateral eye even if the "crossed" eye is the other one. It is usually a same-day surgery.