Simple strabismus: causes, symptoms, and treatment methods

Simple strabismus occurs when the eyes appear deviated, and the classification of strabismus depends on the position of the eye into four sections: supra-strabismus, infra-strabismus, medial strabismus, and exotropia. 

When someone has strabismus, their eyes do not work together and are misaligned. One eye may look straight ahead while the other turns inward, outward, up, or down. This leads to a loss of depth perception and can cause double vision.

While strabismus can develop at any age, it most often occurs in infants and young children. If left untreated, strabismus can lead to amblyopia, also known as lazy eye, which can cause permanent vision loss in the affected eye. Here we will discover the meaning of strabismus, its causes, treatment, and necessary tests.

What is simple periocular?

Simple periocularism is a medical condition that occurs when the eyes are not aligned properly. They both do not focus their gaze in the same direction, and lack of control over the eye muscles causes this disorder. 

Other causes include poor eye muscle balance, false nerve signals to the eye muscles, and problems concentrating, and because of these complications, the eyeballs may converge or diverge, hindering proper eye function. 

This disorder can affect people of any age. The baby may be born with mild strabismus or develop it shortly after birth. If the condition develops in the child after 6-7 weeks, it is necessary to consult a doctor and conduct an examination.

Simple periocular symptoms

If your child has simple strabismus, the strabismus-affected eye may point toward the nose or outward. In less common cases, the eye can point up or down.

Symptoms of simple periocular syndrome include:

• Eye strain, especially at the end of the day.
• Frequent headache.
• Feeling of visual discomfort.
• One or both eyes point in different directions.
• Children can have poor vision in one or both eyes.
• Children with strabismus sometimes close one eye in bright sunlight.
• Children sometimes suffer from double vision.
• Some children tend or turn their heads and face in a certain direction to use their eyes together.

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The most common simple reasons around the eye

Simple periocular pain in children is likely to be caused by premature birth, nerve and muscle damage, or head injury. Adults face the problem in later stages due to underlying problems such as thyroid disease, head trauma, or strokes. Here are the reasons that may lead to periocular edema.

1. Eye muscle problems

The eye muscles are the six muscles that control and coordinate eye movements. Strabismus is more likely to develop when there is a problem with the function of these muscles. Sometimes, strabismus occurs because muscles are not working properly, while in other cases, it is the part of the brain that controls these muscles that causes the misalignment.

2. Neurological and congenital disorders

Disorders that may lead to simple periocularism are:

Cerebral palsy: A congenital disorder that affects muscle strength, movement, and posture.

Hydrocephalus: It is a neurological disorder in which fluid accumulates in the brain.

Down syndrome: This syndrome occurs as a result of a genetic condition and affects mental and physical development.

Brain tumors: Brain tumors sometimes damage the area that controls vision.

3. Genetic causes and visual defects

Congenital strabismus refers to a strabismus condition in a baby who is born with simple strabismus or develops the condition in the first six months of birth. Sometimes, uncorrected farsightedness in a child also leads to strabismus, which is called adaptive esotropia. 

4. Underlying diseases

Diabetes, cataracts, eye tumors, or injuries also play a role in simple periocular development. Strabismus may be a symptom of a rare type of eye cancer known as retinoblastoma. One may also develop strabismus if the condition is genetically related.

How to diagnose simple periosteum at Batal Specialized Complex

A simple periocular diagnosis usually involves a comprehensive eye examination by an ophthalmologist. The following steps are usually taken during the diagnosis process:

• Eye examination by an ophthalmologist

During an eye examination, the ophthalmologist will perform a comprehensive evaluation of the patient’s eye and vision. The doctor will begin by taking a detailed medical history and asking about any symptoms or complaints related to the eyes or vision. They will inquire about the onset of strabismus, any associated symptoms such as double vision or eye strain, and any family history of eye conditions.

• Vision tests

Vision tests are performed to evaluate the visual acuity and clarity of each eye. The ophthalmologist will use an eye chart, such as a Snellen chart, to measure how well a patient can see at different distances. By reading the letters or symbols on the chart, an ophthalmologist can determine the level of visual acuity in each eye. Large differences in visual acuity between the eyes may indicate strabismus.

• Eye movement tests

Eye movement tests are crucial in diagnosing strabismus and evaluating eye movement coordination. These tests help determine whether the eyes are able to move in unison and focus on the target accurately. An ophthalmologist may use different methods, such as asking the patient to track a moving object or perform certain eye movements, to evaluate the alignment and coordination of the eyes. Any abnormalities or deviations in eye movements can indicate the presence of strabismus.

• Medical Ophthalmology

In certain cases, medical imaging techniques such as magnetic resonance imaging (MRI) or computed tomography (CT) may be recommended. These imaging tests help evaluate structures inside the eye, especially the muscles and nerves responsible for eye movement.

Simple periocularism in children

Children with strabismus have eyes that appear to look in different directions, because the muscles in each eye do not work together in a balanced way.

Newborns can sometimes develop strabismus, which appears from time to time. This usually resolves on its own as they gain more muscle control, usually around 6 months of age.

Strabismus can appear later in childhood as well. It may come and go at first and then become more persistent over time, but older children do not get rid of strabismus.

Some strabismus in children is caused by farsightedness. Rare causes of strabismus can include cataracts in one eye or retinal problems.

Strabismus can be very common in premature babies or babies with low birth weight. Eye problems such as strabismus also tend to run in families.

Simple strabismus is also known as strabismus or ”twisted eye”.

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Simple perioral treatment

Simple periocular treatment may include glasses, contact lenses, vision therapy, or eye muscle surgery. If strabismus is detected and treated early, it can often be corrected with excellent results. People with strabismus have several treatment options to improve eye alignment and coordination. They include:

• Glasses or contact lenses

 In some cases, wearing corrective lenses can help straighten the eyes and improve vision.

• Eye muscle surgery

Surgery can change the length or position of the muscles around the eyes so that they appear straight. Often, people who have had eye muscle surgery also need vision therapy to improve eye coordination and keep the eyes irregular again.

• Eye exercises

Your doctor may prescribe eye exercises, which is a structured program of visual activities to improve eye coordination and eye focus. Vision therapy trains the eyes and brain to work together more effectively. These eye exercises can help solve problems with eye movement, eye focus, eye cooperation, and enhance eye-brain communication. Treatment can be done in an optometrist’s office as well as at home. 

• Medicines

In some cases, drug treatments may be used as an adjunct to other treatments or to treat the underlying causes of strabismus. For example, if the underlying cause is related to certain neurological conditions, such as cerebral palsy or stroke, medications may be prescribed to manage those conditions and possibly improve the associated strabismus.

• Simple perioral treatment: multiple options depending on the condition

In addition to the treatment methods mentioned above, addressing the underlying cause of simple periocular disease is critical for effective management. Identifying and addressing any contributing factors can help prevent the condition from developing or recurring. The underlying causes of strabismus can vary, but some common ways to treat the cause may include: 

• Refractive error correction: If refractive errors, such as myopia or farsightedness, are identified as a contributing factor, wearing glasses or contact lenses can help correct vision and relieve pressure on the eye muscles.
• Managing eye muscle dysfunction: In cases where muscle dysfunction is the underlying cause, vision therapy exercises can be used to strengthen weaker eye muscles and improve coordination.
• Treatment of underlying medical conditions: If strabismus is related to an underlying medical condition, such as diabetes, thyroid disorders, or neurological conditions, it is necessary to treat and manage the underlying condition along with strabismus treatment. This may include medications, surgery, or other appropriate interventions.

Tips from Batal Specialized Complex doctors for preventing periocular pain and its complications

Simple periocular incontinence cannot be prevented. But complications can be prevented if detected early enough. At a minimum, children should have an eye health examination before 6 months of age and again between 3-5 years of age.

To prevent or reduce the development of strabismus, our doctors recommend Batal Eye Complex to maintain good eye health and encourage habits that promote good eye health, such as:

• Protect your eyes from injury by wearing appropriate eye protection during risky activities, such as sports or construction work.
• Practice proper eye hygiene, including washing hands regularly and avoiding excessive eye rubbing.
• Take breaks during long periods of visual activities, such as reading or screen time, to reduce eye strain.
• Specify the duration and ensure appropriate viewing distances when using electronic devices, such as computers, tablets, or smartphones. Spending too much time in front of a screen and unhealthy viewing habits can strain the eyes, which can affect eye coordination and increase the risk of strabismus.
• Early intervention for eye diseases: If your child is diagnosed with eye disease or poor vision, follow the recommended treatment plan and seek appropriate interventions immediately. Proper management of underlying eye conditions can help prevent or reduce the development of strabismus.

Get ready to correct your vision with confidence with the experts of the Specialist Champion

At Batal Specialized Eye Complex in Jeddah, we provide the latest techniques for examining and diagnosing simple strabismus under the supervision of an elite group of eye consultants specialized in correcting strabismus in children and adults.

We rely on integrated treatment solutions that include eye muscle exercises, corrective lenses, and microsurgery when needed, to ensure that vision balance is restored and eye alignment is safely improved.

 Don’t wait for your symptoms to worsen — Book your examination today at Batal Specialized Complex in Jeddah and begin your treatment journey to restore your vision balance with confidence and clarity.