Strabismus, commonly referred to as crossed-eyes or an eye turn, is a visual condition where the two eyes point in different directions. An eye can turn in (esotropia), out (exotropia), up (hypertropia), or down (hypotropia). The eye turn may be constant or just at certain times.
It’s also very common to notice an eye turn with fatigue or visually-demanding tasks. A common misconception is held that strabismus is caused by a “weak” eye muscle when that is almost never the case.
Quite simply, the brain controls the eyes, and the brain did not acquire the bilateral coordination to efficiently use the two eyes together as a team.
Can Strabismus be Treated with Vision Therapy?
Yes, absolutely; and it doesn’t require surgery. Surgery-free vision therapy treatment for strabismus takes into account the fact that the BRAIN controls and directs eye movements. Alternatively, eye muscle surgery is exactly limited to it’s title— surgery to cut the eye muscles and place them in a position that is cosmetically straight.
Eye muscle surgery is NOT brain surgery and so often times it merely provides a cosmetic result and no improvement in functioning binocular vision and depth perception. If the brain is not prepared to control and keep the eyes straight, the eyes will ‘go back’ or deviate after the surgery.
Vision therapy works on a neurophysiology level to help rehabilitate the brain’s ability to control eye movements and is medically proven. If a child has a large, constant eye turn at an early age, eye muscle surgery may be considered in those circumstances. But, if the eye turn is not constant, do not be rushed into surgery by the surgeon.
Contrary to the scare tactics used by surgeons, your child will not go blind if he/she doesn’t have the surgery right away, so please find a developmental/functional optometrist who will consider vision therapy and not merely surgery to pull the eyes into cosmetic alignment.
Studies show vision therapy for strabismus is effective at any age, although more favorable results are seen when the problem is detected early.
What is Amblyopia?
Amblyopia, commonly known as lazy eye, is a visual condition where one eye sees poorly even with use of glasses or contact lenses.
Amblyopia can often occur as a direct result of Strabismus (eye turn / crossed eyes) or differences in clarity between the two eyes (due to farsightedness, nearsightedness or astigmatism).
When the brain has a difficult time interpreting the visual information from the two eyes because differences in clarity or alignment, the brain begins to ignore one eye and amblyopia occurs.
Is Amblyopia Treatable with Vision Therapy?
Yes. Amblyopia is ideally treated at an early age, but scientific research shows it can be successfully treated well into adult years. Because it is a brain-based issue and based on neuroplasticity, improvements in functional visual skills controlled by various visual pathways are often seen. Treatment generally consists of:
- Glasses or contact lenses to provide the most balanced prescription for the two eyes to work together
- Vision therapy to equate visual skills between the two eyes, encouraging improvement and stability in binocular functioning, leading to more efficient visual processing and coordination
- Occasional, controlled dynamic patching (current PEDIG/Amblyopia Treatment Study shows more than 2 hours of patching provides no additional benefit) to encourage the poorer seeing eye to work more efficiently.
More information on Strabismus and Amblyopia can be found: