With Straight Eyes and Improved Performance:
Now I am able both to study and read for fun because my eyes don't quit on me. My hand-eye coordination and my sports have also improved. More than anything, I've noticed that my right eye no longer turns in. People used to be able to tell when I was tired because my eye would always become lazy and turn in, but not anymore.
If an eye turns part of the time and is straight part of the time, then the possibility of vision therapy aligning the eyes without strabismus surgery is about 80 percent. If an eye was previously aligned with surgery and then turned again, the chances are still good that vision therapy can help realign the eyes. If the eyes are constantly turned, then it is more likely that some combination of vision therapy and surgery may be needed if the goal is two eyes that not only appear straight but work together for the best depth perception and performance in school, work, driving, or sports.
Not an Eye Muscle Problem
Strabismus is typically a brain problem, not an eye muscle problem. Each eye has six muscles on the outside of the eyeball. These muscles move and align the eyes. In about 5 cases out of a hundred, strabismus is caused by a damaged eye muscle--when the good eye is covered, the turned eye's ability to move in all directions is limited. In most cases, however, the eye muscles are normal: when one eye is covered, the other eye moves freely in all directions. When both eyes are uncovered, an eye deviates because the BRAIN fails to coordinate the muscles to align the eyes.
The Cosmetic Problem
Strabismus causes a problem with appearance. Children on the playground make fun of the child whose eyes look different. Adults with strabismus are often embarrassed because others don't know which eye to look at.
The Seeing Problem
Strabismus affects more than the way we look. It also affects the way we see. When eyes are straight, each eye sends its own picture to the brain. The brain combines these two pictures into a three dimensional image, thus creating "depth perception" or 3D Vision.
When an eye first crosses, the pictures from the two eyes no longer match and the world doubles and runs together. At this point, the person with the turned eye may run into things, knock over drinking glasses, etc. In time though, if the eye is allowed to continue crossing, the child usually learns to ignore or "suppress" the information from the deviated eye. As a result, the child no longer suffers from double vision. At the same time, however, depth perception is lost. And, if the same eye is always turned in, the eye can become so ignored that it goes partially blind. This partial blindness is called "amblyopia."
Treatment of Strabismus
Studies show that children typically do not "outgrow" strabismus. To avoid loss of sight in the turned eye, or loss of depth perception, active treatment is necessary. The most common treatments follow:
If the strabismus is unilateral (meaning that the same eye always turns in) the "good" eye may be patched to make the "bad" eye work and avoid vision loss. While such patching preserves sight, it does little to develop depth perception and can occasionally cause the strabismus to decompensate and the eye to turn in more often.
Sometimes a child is far-sighted so that the muscles inside the eye have to contract for clear seeing. As the brain contracts the muscles it also tells the eye to turn inward. This condition is called "accommodative esotropia". In such cases, glasses will straighten the eye at least temporarily. In about half these cases, if nothing else is done, the eye will turn and surgery be recommended. In other cases, the far-sightedness will gradually disappear after age nine eliminating the need for glasses.
Eye-muscle surgery is used to alter the outside eye muscles to compensate for the difficulty with eye-brain coordination. For a number of patients, such eye-muscle surgery may be a necessary part of treatment. The treatment itself, however, is frequently cosmetic in nature. The strabismus surgery provides a false sense of security by making the eyes look straight to mask the fact that the information from the two eyes is still not being blended properly in the brain. Without this blending , there is nothing to maintain the eyes in proper alignment and additional surgeries may be needed.
Optometric Vision Therapy
Vision therapy works by providing biofeedback to teach the brain to blend the information from the two eyes (fusion). Eye alignment is then rewarded with 3D vision. Frequently this process can align eyes without surgery. In other cases, vision therapy is performed after surgery to help keep the eyes aligned and to improve depth perception for school, sports and driving. Strabismus affects both how a child or adult looks and sees. Successful treatment aligns eyes and creates two-eyed depth perception for seeing the three-dimensional beauty of the world.