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3 years
Hi. What could be the reason of sudden strabismus ( 3 years boy) with 2.5d hypermetropia (putting eyeglasses) and clean MRI. What treatment is needed?
Jan 14, 2015

Dr. Zakia Dimassi Pediatrics

In the setting of absent brain
abnormalities on brain MRI in a child with visual disturbance (hypermetropia in
this case), we think of amblyopia, which 
means that vision in one eye does not develop
well during early childhood. When intervention is done early on, amblyopia is a
correctable problem - delaying treatment makes correction less likely to
succeed and increases the risk of the problem becoming permanent. 

Amblyopia is a condition where the
vision in an eye is poor because of lack of use of the eye in early childhood. Typically
only one eye is affected, but sometimes both eyes can be involved. Amblyopia is
also known as a lazy eye.

Starbismus or squint is a condition
where the eyes do not look together in the same direction. What happens is that
while one eye looks straight ahead, the other eye turns to point inwards,
outwards, upwards or downwards. The resulting of absence of alignment between
the 2 eyes forces each eye to focus on different things. As such, the brain
gets confused (receiving images from 2 different sources from each eye at the same
time), so it ignores the signals from one of the eyes to avoid seeing double.
This means that only one eye is used to focus on objects – this eye becomes predominant;
the other eye grows lazy.

Refractive errors are vision
disturbances secondary to poor focusing of light through the lens in the eye. They
include: short sight (myopia), long sight (hypermetropia) and astigmatism.

In general the same refractive error
is present equally in both eyes. Anisometropia, however, occurs when each eye
is affected by visual disturbance differently, such that one eye may be myopic
(short-sighted), and the other hypermetropic (long-sighted). If this difference
is significant, the brain will not be able to analyze the images coming from
both eyes, and will omit the signals coming from one eye. Usually the brain
selects the eye with the better refractive error in preference. The other eye
(often the most long-sighted one) then becomes amblyopic.



Dr. Salem Abu Alghanam Ophthalmology

most cases of strabismus are due to refraction problems as hypermetropia and myopia ,

and first you need to correct the refraction ,if did not works you may go for surgery .