Strabismus, also commonly known as lazy eye or crossed eyes, is a condition involving the misalignment of the eyes. The extent of the misalignment can vary from slight, that may not be obvious, to significant crossing, which can cause significant problems.
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Physical signs
The signs of strabismus are noticeable changes that may be observed by other individuals, such as eyes that are pointing in different directions. Signs of the condition may include:
- Crossed eyes
- Eyes that do not move together
- Unsymmetrical points of reflection
- Tilting head to the side
- Squinting with one eye
There may also be subtle signs that present due to the reduced ability of the individual to gauge depth, such as being less spatially aware and coordinated than usual.
There are different types of strabismus, which are classified according to the turn of the eye that is misaligned. This includes:
- Exotropia - outward turn of the affected eye
- Esotropia - inward turn of the affected eye
- Hypertropia – upward turn of the affected eye
- Hypotropia – downward turn of affected eye
Patients with exotropic strabismus are more likely than those with esotropic strabismus to be affected by secondary symptoms of the condition, such as psychosocial difficulties.
Patient symptoms
The symptoms of strabismus are the effects that are noted by the patient and may include:
- Double vision
- Decreased depth perception
- Jittery vision
- Eyestrain
- Headache
- Fatigue
The brain's response to the double vision that results from strabismus is to block out the vision of the weaker eye. This is beneficial in that the patient is able to see and focus on objects more easily, but is associated with a decreased ability to gauge depth. Over time, many individuals are able to compensate for this by using monocular cues to judge depth.
Psychological effects
For many patients that are affected by strabismus, it is the secondary symptoms of the condition such as psychosocial difficulties that have the greatest impact on their quality of life.
Affected children are more likely to experience inhibition, anxiety and emotional distress, which can affect the way they interact with other children. It can be difficult for them to communicate with their peers, as they have problems using simple social cues such as eye contact and connection. As a result of this, they may feel isolated from their peers, leading to embarrassment or anger.
Patients may cope with stressful situations in a variety of different ways, including avoidance of activities, distraction of attention from the condition or adjustment of their approach activity to improve the situation.
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Quality of life
Strabismus has been linked to a poorer quality of life, which is primarily attributed to socioeconomic factors and the psychosocial effects of the disease.
Affected individuals are likely to have more difficulty finding employment than members of the general population, leading to lower overall socioeconomic status. Likewise, difficulty interacting with other people can lead to altered overall happiness, reducing the quality of life.
References
Further Reading