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Treating Adult Strabismus by Monica Bratton, M.D.

September 21, 2020

Dr. Monica Bratton is a pediatric ophthalmologist and adult strabismus specialist.

Strabismus, or eye misalignment, refers to a condition in which the eyes do not align. Strabismus may be present at birth, or it may develop later in life. Also, it may be present at all times, or it may only occur intermittently. Patients with strabismus may notice no visual symptoms, or they may have blurry vision, see double, or struggle with depth perception. Visual symptoms from strabismus can also lead to eye strain and headaches. There are a variety of options available for treating strabismus, and your recommended treatment course will depend on your unique condition.

Types of Strabismus

There are many different types of strabismus, but some of the most common are esotropia, exotropia, hypertropia/hypotropia, and cyclotropia.

  • Esotropia refers to when one or both eyes turn inward.
  • Exotropia refers to when one or both eyes turn outward.
  • Hypertropia and hypotropia refer to when the eyes are not vertically aligned.
  • Cyclotropia refers to when the eyes have a torsional misalignment and images appear to tilt relative to one another.

What Causes Strabismus

Eye movement is controlled by six muscles that must all work together for eyes to properly align. Eye alignment can be affected when one or more of these muscles is not functioning properly. Most adults who have strabismus were born with it or developed it as children. However, strabismus may also develop in adulthood.

Strabismus can be hereditary, or it can be caused by a condition that affects the eye muscles. These conditions may include:

  • Diabetes
  • Thyroid disease
  • Myasthenia gravis
  • Brain tumor
  • Stroke
  • Head injury

Strabismus can run in families, though not all family members will develop strabismus and family members may display different types of strabismus.

Treatment Options

Treatment for strabismus depends on the type and severity of the condition. The following are the traditional treatment options recommended for patients with strabismus:

  • Eye muscle exercises — Eye muscle exercises can be used to help patients with convergence insufficiency, which occurs when eyes do not properly align for near vision.
  • Eyeglasses or contact lenses — Eye misalignment caused by farsightedness can be corrected with traditional glasses or contacts.
  • Eye patch — If one eye appears to be normally aligned while the other is misaligned (lazy eye), the stronger eye can be covered with an eye patch. The eye patch forces the patient to rely on the weaker eye, which over time can help strengthen the vision.
  • Prism eyeglasses — Prism correction is used in patients who experience double vision. The prism can be attached to a pair of eyeglasses or built into the lenses. The purpose of the prism, which may be used on one or both eyes, is to bend light before it enters the eye so that the images received in the brain from each eye can properly align.
  • Botox® — If stiff muscles are causing eye misalignment, Botox injections can be used to weaken the muscles causing the misalignment. Eye alignment may be improved temporarily or permanently.
  • Surgery — In surgery, the eye muscles are repositioned or shortened by an ophthalmologist so that the eyes are properly aligned. Surgery may be used on its own or in conjunction with other treatment methods.

Strabismus is a complex ocular condition with a variety of treatment options. If symptoms of strabismus are negatively impacting your life, it is recommended to see a strabismus specialist, who can assess your unique condition and explain the most fitting course of treatment. Although many regard strabismus as a condition that is merely cosmetic, it can seriously impact quality of life, and treatment is often covered by insurance. Although treatment for strabismus can be involved, it can also be very rewarding.

To learn more about how we treat strabismus at the Marietta Eye Clinic, click here.

More About Strabismus Specialist Monica Bratton, M.D.

Dr. Bratton is an ophthalmologist at the Marietta Eye Clinic who specializes in pediatrics and adult strabismus. Dr. Bratton graduated with her bachelor of arts from the University of Tennessee and received her medical degree from the University of Tennessee College of Medicine. She is a fellow of the American Academy of Ophthalmology and a member of the American Academy of Pediatric Ophthalmology and Strabismus and the Association for Research in Vision and Ophthalmology. Read her full bio here.

References and Additional Sources

The American Academy of Ophthalmology (AAO) is the world’s largest association of eye physicians and surgeons. It describes itself as a “global community of 32,000 medical doctors who protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public.” Its website is a great resource to learn more about how to care for your eyes.

The American Optometric Association (AOA) describes itself as the leading authority on quality care and an advocate for our nation’s health, representing more than 44,000 doctors of optometry (O.D.), optometric professionals, and optometry students. 

What Is Adult Strabismus?

https://www.aao.org/eye-health/diseases/what-is-strabismus

Strabismus in Children

https://www.aao.org/eye-health/diseases/strabismus-in-children

Strabismus

https://aapos.org/glossary/strabismus

What Is Prism Correction In Eyeglasses?

https://www.aao.org/eye-health/glasses-contacts/what-is-prism-correction-in-eyeglasses

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