Adult Strabismus

Adult strabismus is a misalignment of the eyes, where the eyes cannot work together to focus on and track objects properly. While strabismus is common in children, it can also affect adults, but they may experience somewhat different symptoms than younger patients. In the following, we will learn about everything related to the treatment of strabismus in adults, and how effective it is to do exercises to treat strabismus in adults.

What are the causes of strabismus in adults?

Before we discuss how to treat strabismus in adults, let us know what causes strabismus in adults or adults.

Strabismus in adults occurs when there is a malfunction in the muscles or nerves associated with eye movement or associated with the brain.

The most common causes of strabismus in adults include:

• Childhood strabismus that was not corrected.
• Thyroid disease.
• Diabetes.
• Stroke.
• Injury to a tumor.
• Aging and aging.

What are the symptoms of strabismus in adults?

Adults with strabismus often experience additional symptoms, including:

• Double vision (diplopia): This is the vision of two images of the same thing.
• Visual confusion: This is the vision of two different images superimposed on each other.
• Rapid image transition: The images captured in the field of vision change significantly as the focus shifts from one eye to the other.
• Abnormal head position: Adults with strabismus often turn their faces or tilt their heads due to double vision.
• Loss of depth perception: This leads to problems with hand-eye coordination, driving, or various sports activities.

How to treat squint in adults

There are different ways to treat squint in adults depending on its cause and severity, but all of them have the same goal of restoring binocular vision. Treatment options include:

• Glasses to correct double vision.
• Eyeglasses or contact lenses.
• Eye exercises.
• Botulinum toxin injections.
• Surgery.

Glasses in the treatment of squint in adults

A prism can be attached to glasses or made as part of the lens to help people with mild double vision.

Treatment of squint with exercises for adults

An eye doctor can teach you exercises that help the eyes focus inward.

1. Pencil push-up exercises

Pencil push-up exercises are simple eye exercises that make both eyes point to the same fixed point. They are also known as convergence exercises.

1. Start by holding a pencil at arm's length pointing away from you.
2. Focus your eyes on the pencil.
3. Slowly move the pencil towards your nose.
4. Maintain your focus for as long as possible, but stop if your vision becomes blurry.
5. The exercise can be repeated.

2. Barrel cards

This is one of the exercises for treating squint in adults.

1. Draw three barrels of graduated size in red along one side of the card.
2. Do the same thing in green on the other side.
3. Hold the card vertically and horizontally against your nose so that the largest barrel is the farthest away.
4. Stare at the farthest barrel until it becomes one image with both colors.
5. Hold your gaze for about five seconds, then repeat with the medium and smaller barrel images.

Treatment of squint in adults with botulinum toxin injections

In some cases, botulinum toxin injections into the eye muscles can help treat squint. It paralyzes the muscles that prevent the eyes from aligning properly. The effect can last for only a few months, or it can improve eye alignment permanently.

Surgery for strabismus in adults

Your eye doctor may recommend surgery if other treatments for strabismus in adults have not been successful.

1. During strabismus surgery, the eyelids are opened with a blepharoscope. The surgeon can access the eye muscles by making a small incision in the conjunctiva, which is the thin layer of transparent tissue that covers the white part of the eye.

2. The surgeon will either strengthen the eye muscles, weaken them, or reposition them according to your specific needs and the surgeon's vision.

3. Most patients return to their daily routine within a week.

4. In some cases, the surgeon will use an adjustable suture technique in which a temporary knot is used.

5. The surgeon can use this to adjust the alignment of the eye after surgery.

6. This adjustment is usually done when the patient is awake and can be done within one day after surgery.

7. Using adjustable sutures can help to achieve the correct alignment and also reduce the need for further muscle surgery in that eye.

8. The surgeon may ask some patients to continue other treatment protocols, such as glasses or exercises, after strabismus surgery.

Treatment of pseudostrabismus in adults

Pseudostrabismus is a condition in which the eye shape, or the visible area of the white of the eye, suggests that there is strabismus in the eye, but in fact, this does not affect the vision for the person as in cases of original strabismus, but rather it is only an apparent problem, so there is no need to treat pseudostrabismus in adults.

Finally, do not coexist with the problems and complications caused by strabismus, with the help of an eye doctor, you can find a treatment for strabismus in adults.

Now, after you have learned everything about how to treat strabismus in adults, do not hesitate to consult Dr. Osama Hakim, consultant of ophthalmology and eye surgery, strabismus, eyelid, and lacrimal duct surgery at Moroccan Eye Hospital in Dubai and founder and director of Medical Eye Center in Egypt.