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School of Medicine
Strabismus & Amblyopia
Strabismus & Amblyopia
Wilmer's Pediatric Ophthalmology and Strabismus Service specializes in the treatment of strabismus (deviated eyes) in both children and adults, amblyopia (known as "lazy eye"), blinding retinal diseases of premature babies, congenital cataracts, blocked tear ducts, and pediatric neuroophthalmologic disorders. Special care is given to provide a friendly atmosphere for children undergoing examination. For example, techniques using mirrors have been developed to examine some types of eye problems without having to place anything close to the child's face. This caring approach, and others like it, keep children and their families comfortable and relaxed. Strabismus (crossed eyes or eyes that turn out) is a misalignment caused when one or more of the six muscles controlling the eyes fail to work properly. It prevents the eyes from working together, initially causing vision impairment, double vision or faulty depth perception. Strabismus occurs in two to five percent of all children. Unable to outgrow it, children may lose vision in one eye, which then succumbs to amblyopia if the root cause is not treated in early childhood.
Traditionally, ophthalmologists diagnosing children with strabismus and/or amblyopia alternately block vision of each eye, a process that annoys and distresses young patients. But at Wilmer, new techniques are being developed that make diagnosing these disorders as easy as watching television. As the children watch cartoons, optical wizardry permits physicians to examine the eyes without ever placing anything close to the child's face. Another remarkable innovation in the diagnosis of strabismus and amblyopia at Wilmer is a new computer-based test of depth perception that can be used with children as young as four months. Using a moving target and a video eye-tracker, a physician can determine within seconds whether the child's eyes work together normally or whether the child shows signs of strabismus.
Treatment of strabismus usually involves glasses, eye muscle exercises and/or surgery. One conventional treatment for amblyopia has been to place an adhesive patch on the good eye - not a popular treatment with most children or their parents. The pediatric ophthalmologists at Wilmer have been in the forefront of using alternatives, such as drops or special glasses, simply to blur the good eye temporarily, thereby strengthening the weaker eye. Children are much more receptive to such methods, so better results are achieved, with minimal psychological trauma. The best outcomes result when people are treated early in life, but adults with strabismus also can have their eyes straightened. Treatment can eliminate double vision or eye strain, enlarge the field of vision or simply restore normal appearance. If surgery is necessary, our doctors can realign the eyes with a technique rarely used in young patients. Using this technique, known as adjustable sutures, the surgeon can fine-tune the eyes into exact alignment several hours after surgery is completed, much like aligning the headlights of a car. Some types of strabismus now can be treated with a new drug instead of surgery. The drug temporarily weakens muscles. Injected into the stronger of a pair of muscles, it eases the pull, allowing the weaker muscle to gain strength. When the drug wears off in about two months, proper muscle balance and eye alignment often are restored.
> Treated by Wilmer's Pediatric Ophthalmology and Strabismus Service
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