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Strabismus and Amblyopia (2004 Edition)

1. What is strabismus?

A: Strabismus refers to when looking at one target, one eye looking at the target, and the other eye deviating from the target. What we usually call "cross-eyed eyes" is esotropia, and commonly known as "push window eyes" is exotropia.

2. How to detect strabismus early?

Strabismus may occur if one of the following situations occurs:

  • Parents find out if their child has squinted eyes when they are not paying attention or their whole body resistance is reduced;
  • Have a habit of looking at things tilted;
  • Easily afraid of light, often squinting to look at things.

3. What are the dangers of strabismus?

A: The dangers of strabismus can be seen from three aspects: appearance, visual function, and psychology, among which the effect on visual function is the most serious. First, the appearance is unsightly, which causes children to have psychological inferiority. Second, the effect on visual function, which affects the development of vision, the vision of strabismus is often poor, often causing severe amblyopia, and patients with strabismus are generally not Three-dimensional sensation; again, some strabismus can affect children's physical development, such as face asymmetry and crooked neck, if left untreated.

4. Will strabismus be treated without treatment? Or is it really not too late to have surgery before growing up?

A: To answer this question, let's first understand the development of binocular vision. The sensitive period of visual development is from birth to eight years of age, of which the period from birth to three years is the critical period; the mature age of vision and visual function is generally before the age of six. Strabismus that occurs during these times can seriously affect the development of vision and visual function. After treating the strabismus after the sensitive period of visual development, the affected vision and visual function cannot be restored.

5. What is the best age for children's strabismus surgery?

A: It depends on the type of strabismus, the condition of the eyes, and the time of onset:

  • Strabismus caused by congenital mechanical factors, if the ligament or muscle fascia is abnormal, the sooner the better.
  • Most scholars with congenital strabismus believe that surgery is best for establishing binocular vision in 6-18 months after birth.
  • Unilateral esotropia or strabismus accompanied by amblyopia, do not rush to surgery, treat amblyopia first, and then perform surgery after the eyesight is balanced.
  • Small degree strabismus, intermittent strabismus, and strabismus in children with unstable strabismus should be closely observed without changing the operation.
  • Late onset, such as strabismus that occurs after the age of 2 should be operated during the age of 3-6 years.

6. What are the treatments for strabismus?

Answer: The treatment of strabismus should be as early as possible. Currently, the main treatment methods include surgery and non-surgery. Most strabismus is corrected by surgery. For some children with esotropia, wearing glasses can partially or completely eliminate strabismus, and some small degree strabismus can be treated by wearing a prism or training binocular monocular function to re-establish binocular function.

7. What is amblyopia?

Answer: Amblyopia means that there is no obvious organic disease in the eyeball, and those who correct their vision after the examination of the ciliary muscle paralysis are less than 0.8.

8. How is amblyopia formed?

Answer: Due to congenital or inadequate light stimulation entering the eye during the critical period of visual development, the opportunity for the fundus macular to form a clear object image and / or unequal visual input between the two eyes may cause a clear and blurred object image. Loss of vision in one or both eyes due to competition.

9. How can I find my child's amblyopia early?

A: Parents found that when the child reads and writes, his eyes are too close to the book, if he looks at the characters together, whether there is one eye, the other eye is skewed; whether he always tilts his head when looking at people, regardless of whether If you have any of the above, you should go to the hospital regularly for regular inspections, which is the most effective way to detect amblyopia early.

10. How to distinguish the severity of amblyopia?

Answer: After correction of ametropia, distant vision <= 0.2 is severe amblyopia; corrected vision is 0.25-0.5 is moderate amblyopia; corrected vision is 0.6-0.8 is mild amblyopia.

11. Can amblyopia be cured?

Answer: For functional amblyopia caused by high hyperopia and ametropia, early detection, and timely treatment results are satisfactory.

12. What are the common treatments for amblyopia?

A: The key to amblyopia treatment is accurate optometry (children also need dilated optometry, wear appropriate glasses, and perform treatment on this basis).

(1) Traditional covering method + fine eyesight homework: cover eyes with good vision, force amblyopia (wearing glasses) to see things, and do fine eyesight homework at the same time, such as: training with amblyopia plugs to stimulate the development of the optic nervous system, Improve the vision of amblyopic eyes. This method is simple and easy to apply, and is applicable to strabismic amblyopia and ametropic amblyopia with reliable results.

(2) Afterimage + red light stimulation: firstly use the afterimage to suppress the peripheral retina, and then use red light as a stimulus to stimulate the macular area of the amblyopic eye to improve vision. This method is simple and easy to perform, with short treatment time and quick results. It is especially suitable for severe amblyopia with poor fixation properties. Other methods include depression therapy and visual stimulation therapy (ie, CAM stimulator).

13. How should parents guide their children to treat amblyopia?

Answer: (1) It is necessary to fully understand that the process of amblyopia treatment is slow and the vision is gradually improved. Therefore, parents cannot be rushed, and they must be patient and persistent.

(2) Be patient and persuade children to wear glasses. In addition to bathing and sleeping, it is very important to wear glasses, especially when covering healthy eyes. It is important to connect the legs with a chain to prevent the glasses from breaking.

(3) Guide the child to wear glasses when looking at nearby objects, especially when drawing or writing. This can often achieve more results with less effort.

(4) For children with moderate and severe amblyopia, in addition to wearing a foreign country, they must insist on going to the hospital for amblyopia training and treatment. Parents who use amblyopia stimulators (CAM) should encourage their children to draw pictures carefully and try to draw accurately.

(5) Insist on follow-up consultation. Children 2-3 years old once every two weeks, older children once a month, ask the doctor to check the fundus, vision, etc., dilated pupillary optometry once a year. In short, because of the young age and poor self-control, it is very important for parents to patiently guide their children in treatment.

14. Are there drugs and surgical treatments for amblyopia?

A: So far, there has not been any drug or surgical treatment that has a definitive effect on amblyopia. At present, levodopa drugs are also used in the clinical treatment of amblyopia, but there is not enough evidence to show its exact effect on amblyopia. As for surgery, it is generally used to treat the causes of amblyopia, such as strabismus surgery. The surgery itself cannot improve amblyopia The patient's vision; that is, no surgery can directly treat amblyopia.

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