From the Guidelines
Strabismus in babies can lead to several problems, including amblyopia, poor depth perception, and binocular vision issues, if not addressed promptly, and early detection and treatment are crucial to prevent permanent vision loss and other complications 1. The main concern with strabismus in babies is the development of amblyopia, also known as lazy eye, where the brain begins to ignore visual input from the misaligned eye, potentially causing permanent vision loss.
Key Problems Associated with Strabismus in Babies
- Amblyopia (lazy eye)
- Poor depth perception
- Binocular vision issues
- Refractive errors
- Strabismus (misalignment of the eyes) Babies with strabismus may also develop poor depth perception and binocular vision, affecting their ability to judge distances and coordinate eye movements.
Importance of Early Detection and Treatment
Early detection is crucial, ideally before 6 months of age, as the visual system is most adaptable during the first few years of life. Treatment options depend on the cause and type of strabismus but may include:
- Prescription glasses to correct refractive errors
- Patching therapy (covering the stronger eye for several hours daily to strengthen the weaker one)
- Surgery to realign the eye muscles
- Botulinum toxin injections in certain cases Parents should watch for signs like one eye turning in, out, up or down, especially when the baby is tired or sick. Regular pediatric check-ups that include vision screening are essential, as babies won't complain about vision problems. Follow-up evaluation is essential, even when initial treatment results in good binocular alignment, as the child remains at high risk for developing amblyopia, losing binocular vision, and having a recurrence of strabismus 1.
From the Research
Problems in a Baby with Strabismus
- Strabismus occurs when one eye cannot focus on an object or point in the same direction as the other eye, resulting in the eye turning inward, upward, downward, or outward 2
- Babies with strabismus may experience diplopia (double vision) or vision loss, and may develop compensating postures such as a head tilt to try to see clearly 2
- Strabismus can be associated with other eye conditions, such as amblyopia (lazy eye), which can lead to permanent vision loss if left untreated 2, 3
- Risk factors for strabismus and amblyopia include premature birth, low birth weight, and family history of eye problems 2, 4
Potential Complications
- Untreated strabismus can lead to permanent vision loss, as the brain may learn to suppress the image from the affected eye 3
- Strabismus can also affect a child's self-esteem and social interactions, particularly if they are teased or bullied about their appearance 3
- Early detection and treatment of strabismus are critical to prevent long-term vision problems and promote normal eye development 4, 5
Treatment Options
- Nonsurgical management options for strabismus include eyeglasses, prisms, and onabotulinumtoxinA injections 2
- Surgical management options may be necessary to realign the eyes and improve vision 2, 5
- Treatment outcomes may vary depending on the age of the child and the severity of the strabismus, with younger children tend to have better outcomes 5