Question:
What are the treatment options for adult strabismus?
Answer:
Strabismus is the condition in which the eyes are not aligned with one another. The disparity may be vertical, horizontal, or torsional, and may be present in all or only some positions of gaze.
Adult strabismus is managed according to the cause. Untreated childhood strabismus is common in adults and is largely a cosmetic problem, since there is not usually double vision and the patient is usually well adapted to the circumstances. Sometimes, there is a breakdown of previously controlled strabismus, which can be spontaneous or follow illness, stress, or trauma. Many drugs and alcohol also contribute to the occurrence of this regression.
Spontaneous strabismus in adults is often accompanied by double vision. Diseases such as thyroid orbitopathy, pseudotumor of the orbit, brain tumors, carotid cavernous fistula, orbital trauma, intracranial aneurysms, diabetes mellitus, myasthenia gravis, pseudotumor cerebri, etc, need to be ruled out.
While the investigation is underway, placing a patch over one eye should give symptomatic relief to the double vision. Covering either one should work, or the strabismus is not the cause of the double vision.I prefer to patch the normal eye if only one seems to be involved. Prism lenses place on the eyeglasses will also relieve the double vision and make the eyes appear straight. Initial efforts must be made to find the cause and treat it.
If none is found or the strabismus persists after treating the cause, some cases are managed by injecting Botox into the muscles that move the eyes. This is, of course, temporary, by may work long enough for the process to heal itself. After six months, if the strabismus is stable, surgery on the extraocular muscles is often indicated and is highly successful. This can be done under general or local anesthesia, and is an outpatient procedure.
Answered by:
Richard G Shugarman, MD
Categories:
Eye Diseases, General Eye Health
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