Infantile strabismus, a phenomenon far from uncommon as it affects about 3% of children, is not a real disease but a visual defect caused by the malfunction of the extrinsic eye muscles of the eye; this muscle deficit causes a deviation of the visual axes and therefore the synchronism between the two eyes is lacking and the binocular vision is altered.

It is important to note that this defect is very frequent and absolutely natural in infants: in this case it is defined as essential infantile esotropia, characterized by the deviation towards the inside of one or both eyes.

Infants under 6 months of age have not yet developed the ability to orient the visual axes in the same direction; after 6 months, generally, this ability is acquired and transient strabismus disappears naturally, while otherwise we speak of true strabismus and it is necessary to consult an ophthalmologist.

An orthoptic eye examination between 6 and 9 months is recommended to rule out microstrabismus, evaluate the presence of binocular vision and also ensure the absence of congenital malformations such as cataracts and glaucoma.

Types and Causes of Strabismus

The incorrect convergence of the visual axes can give rise to different types of strabismus:

  • CONVERGENT STRABISMUS or ESOTROPIA: when one eye is able to look straight while the other deviates inward
  • DIVERGENT STRABISMUS or EXOTROPIA: when the cross-eyed eye deviates outwards
  • VERTICAL STRABISMUS: when the eye deviates upwards or downwards.

Regardless of its type, when talking about childhood strabismus it is necessary to recognize true strabismus, which is the main cause of amblyopia, from the forms of pseudostrabismus, linked to a particular eyelid conformation.

In the first case, the phenomenon is, as has been said, caused by the fact that one or both eyes are not well aligned due to a muscular deficit; in the second case, pseudostrabismus is instead determined by an excessive development of the epicanthus, that is, that fold of skin that partially covers the sclera (the white part of the eye), which gives the impression that the ocular axes are deviated and therefore simulates the presence of strabismus.

Care for Pediatric Strabismus

Depending on the severity of the phenomenon and the type of strabismus described above, the ophthalmologist may indicate the best cure.

To date, several therapeutic avenues are available:

  • Use of eyeglasses capable of correcting visual disturbances such as nearsightedness, farsightedness and astigmatism, which can contribute to the development of strabismus;
  • Botulinum toxin injections, which injected into one of the muscles responsible for the abnormal movement of the eye, weakens the treated area, allowing the eyes to realign (this is however a temporary solution);
  • Learning of particular eye exercises to improve the movement of the eye muscles and stimulate the brain and eyes to work in a coordinated way;
  • Minimally invasive strabismus surgery to strengthen, weaken or move the muscles that move the eyeballs to a different position and thus realign the visual axes.

Blue Eye, eye microsurgery center: it is a well-established private reference structure in the prevention and treatment of different eye diseases, thanks to the experience of the professionals who work in it and the use of cutting-edge technologies. We are in Milan, in Piazza Fontana 6 and in Vimercate, in Via Torri Bianche 7, Palazzo Faggio.