Eye disease · Overview

Strabismus: the diagnoses at a glance

Strabismus is the malpositioning of one or both eyes. The misalignment can occur from the parallel optical axis inwards, outwards or also in all other directions. The eye is consequently not directed straight ahead but deviates from the normal target direction. Due to the misalignment, the images transmitted to the brain are not transmitted identically, resulting in double images. Strabismus can be congenital, but can also occur at a later stage, and the cause can almost always be diagnosed. 


True vs. fake strabismus 

In the above scenario, we are dealing with “true” strabismus. In our practice, however, we also frequently observe “fake” strabismus, where the observer believes that one of the other person’s eyes is looking in a different direction. In reality, however, it is only due to the palpebral fissure, respectively the asymmetrical facial anatomy of the opposite person. This is genetically predisposed and cannot be treated. 


Different diagnoses  

Strabismus can occur in different forms. Latent strabismus (heterophoria) usually occurs in certain situations, for example when the person is tired or has drunk alcohol. The two eyes do not work together in such situations, and double vision occurs, usually accompanied by a headache. Another diagnosis is paralytic strabismus, also called strabismus paralyticus. In this condition, one or two eye muscles work insufficiently, completely blocking individual eye movements. Strabismus paralyticus can occur suddenly and at any time, regardless of age. 


Strabismus in children 

Another form is concomitant strabismus, which occurs at a young age or already at birth. By the age of seven, our vision and pixel resolution develops along with color vision and processing of the complete visual field, i.e., the fusion of both received images into a spatial whole. If the squinting eye does not provide the associated brain hemisphere with the same information as the other eye, the brain decides in favor of one side. The consequence is the underdevelopment of the other side. One eye becomes weak-sighted, this is the diagnosis of amblyopia. If this problem is not diagnosed or is diagnosed too late, lifelong symptoms can occur. If diagnosed early enough and with specialist care, a complete cure is almost always possible.  


For all of the above diagnoses, we always recommend consulting a specialist. Strabismus is a serious condition that requires prompt evaluation and appropriate treatment. Do you suspect strabismus? You are welcome to make an appointment for an initial consultation with me. Contact me now via e-mail or telephone – I look forward to hearing from you!