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Crossed eyes a common vision condition in children

Tyrone Hospital received a vision health grant from the National Institute of Health, National Eye Institute. The grant is being used to provide vision
screenings for preschool-age children. As part of the grant project, information about children’s vision health is being provided to the community through a series of news articles made possible through the cooperative efforts of Tyrone Hospital, Heimer Eye Care Associates and The Daily Herald.

Wandering eye, wall eye, and crossed eyes, they are all commonly used terms to describe a misalignment of the eyes called strabismus, a vision condition that is found in up to five percent of children.
Strabismus occurs when one or both of the eyes turns in, out, up, or down when a person is trying to visually focus on something. Jill Finke, O.D., an optometrist at Heimer Eye Care Associates in Tyrone, said strabismus may be present at birth, it may become apparent in toddlers, or in children as old as age six. Strabismus may also appear at any time in life as a result of illness or injury.
Dr. Finke said, “Strabismus can cause double vision and problems with depth perception. If these problems are not properly addressed, it can affect a child’s normal visual and motor development.”
If both eyes do not align, only one eye is actually focused on the object you are looking at. The other eye, the one that is out of alignment, is looking at something else.
“Since both eyes are not aimed at the same point, it can cause double vision,” said Dr. Finke. “The eyes and the brain work together for vision. If there is double vision, the brain may try to compensate for it by suppressing vision in one of the eyes. The longer suppression has been in effect, the more difficult it will be for the child to re-establish vision using both eyes.”
Strabismus can also cause problems with depth perception. Depth perception allows us to see where objects are in relation to our own body.
The eyes pick-up a variety of visual information that helps us determine how high, deep, and wide an object may be and basically, this is the information that forms our depth perception.
In normal vision the two eyes generally pick up the same visual information, but each eye also picks up some visual details that the other eye doesn’t. The brain combines the information it receives from each eye to form one image. The brain matches up the similarities and adds in the small differences seen by each eye. The small differences between the two images significantly affect the quality of the final image. With strabismus, since both eyes are not properly focused on the same image, some of the visual details are lost and it is this loss of visual information that contributes to problems with depth perception.
Dr. Finke said many of the activities that children perform rely heavily on depth perception – for example throwing, catching, or hitting a ball, stepping off of a curb or step, reaching out to take someone’s hand, or pouring into a container.
“Vision compromised by strabismus can affect a child’s ability to perform a variety of tasks.”
There are different types of strabismus and each type has its own causes, characteristics, and appropriate treatment plan.
For instance, when the eye tends to wander all of the time, it is called constant strabismus. When the eye wanders only some of the time, it is called intermittent strabismus. With intermittent strabismus, the eye misalignment might only occur occasionally such as during stressful situations or when the person is ill.
Many things can cause a strabismus including genetics, inappropriate development or problems with certain parts of the brain, and injuries or other problems with muscles or nerves associated with the eyes.
Dr. Finke said children do not outgrow strabismus, in fact, the condition may worsen without treatment. Early detection and treatment is very important in all cases. Treatment will depend on the condition and individual.
Treatment for strabismus may include single vision or bifocal eyeglasses, prisms, vision therapy, and in some cases, surgery. Eyeglasses may be prescribed to eliminate the eye turn and/or eliminate any optical difference between the eyes. In some cases, an eye patch may be used to stimulate an eye in which the vision has been suppressed or “turned off”. Vision therapy, a non-surgical treatment, involves using equipment and/or optical devices to train the eyes to work together.
Dr. Finke said there are things that parents can do also.
“Infants or young children should be encouraged to do things which involve hand and eye coordination. Movement and hand eye tasks speed the improvement in treatment of strabismus.”
Dr. Finke said it is important for young children to have a comprehensive vision exam so conditions like strabismus or other vision problems can be detected and corrected early. Uncorrected vision conditions can affect a child’s development and their quality of life.
According to the American Optometric Association, as much as eighty percent of learning occurs through vision. The longer a vision problem goes undiagnosed and untreated, the more a child’s brain learns to accommodate the vision problem. A vision problem can strongly impair their overall development.
Dr. Finke said the general guidelines for children to have vision exams is to have a comprehensive  eye exam at age one, age three, and every two years afterwards, especially if there is a family history of any type of vision condition.
“Parents should pay careful attention to their children’s eyes and if they notice even the slightest misalignment it is important to have their child receive a comprehensive eye evaluation by an eye care professional.”
Tyrone Hospital received a vision health grant from the National Institute of Health, National Eye Institute. The grant is being used to provide vision screenings for preschool-age children. As part of the grant project, information about children’s vision health is being provided to the community through a series of news articles made possible through the cooperative efforts of Tyrone Hospital, Heimer Eye Care Associates and The Daily Herald.