qa14

Question

As you can see we have been to a number of pediatric ophthalmologist and ophthalmologist. My daughter is 8 yr. old and since she was about three she has been diagnosed with strabismus some of the ophthalmologists say right away that she needs surgery,some have done patching & eyeglasses all to no avail then in the end determining that she needs surgery. We are quit hesitant on surgery because of the success rates. We have friends who have had their children go threw a number of surgerys to correct the same problem. we even had one ophthalmologist say leave her alone and bring her back every 6 months for re-evaluation. We are presently trying a new pediatric eye doctor he has done all the necessary testing and says she has esotropia. His recommendation was percription glasses to help correct some of the crossing then possible surgery to correct the rest. We will take the necessary procedure and follow threw he want us to fill the perscription then have her wear the glass! es full time and see her back in 6 wks. She has a nuerological condition though,one side of her brain did not fully develop the left hemisphere and this is the right eye that is lazy We are wondering if all of this is do to nueological difficulties and the! surgery would be nescessary or would it be only cosmetic? Please help us to understand?????????

(Charmaine Perez)

Answer:

Dear Charmaine,

Please pursue the treatment suggested by your current ophthalmologist. He is correct in first prescribing glasses to reduce the esotropia (assuming that some farsightedness is present) and then do surgery if the remaining angle of strabismus is still noticeable. Eight years is a little late to start surgery but it is still very well possible.
Indeed, the main reason for strabismus surgery in children is cosmetic, but that should not keep you from having surgery done, because after age ten it gets progressively more difficult to perform surgery, because the adaptations that the brain develops for strabismus in childhood (like anomalous retinal correspondence) are more difficult to reverse.
I hope the lazy eye has been treated sufficiently by patching; it is too late to change that now.
Maldevelopment of the brain indeed increase the risk for strabismus, but usually is not the only reason for the strabismus to occur.

(Herb Simonsz, MD, PhD)

_{Note: To contact contributors to this page, replace [AT] in the e-mail address by @.}