Strabismus treatment

Under certain types and stages of strabismus, patient could be fully recovered. The traditional method of treatment is patching or occlusion, when an opaque bandage is applied to the second normal eye to activate the vision of the squinting eye. It should be combined with a course of special exercises. Treatment of strabismus up to this method requires a lot of time. If within 1.5–2 years the abovesaid measures do not help, other treatment has to be used.

 

Today in the treatment of strabismus there are two main methods: surgical procedure and therapy by means of special prism glasses.

Prismatic correction as a treatment of strabismus method was applied for a long time, back in the early 50s. For the converging strabismus were used prisms based to the temple, for the with diverging strabismus were used based to the nose (for constant wear). Prisms were prescribed to transfer the image of the squinting eye to the central fossa of the retina (macula) to stimulate the integration of images of both eyes. However, this type of strabismus treatment is not widespread, since it is almost impossible to use ophthalmic prisms, usually glass, with a force of more than 8-10 prism diopters, because of the large weight and dimensions of such prisms.

 

 

The Fresnel elastic microprisms that appeared in the 70s are mostlu overcome mentioned shortcomings. According to the ophthalmologists who applied them, positive results have been obtained, especially in cases of postoperative residual angles with vertical deviations and in the last stages of the treatment of friendly strabismus, when binocular functions are being formed. The main manufacturer of such microprisms is the company "3M" (USA)

The relief side of the disc is protected from the external environment by a protective plate, which is hermetically sealed by means of an ultrasonic welding with a microprism element. When such microprisms are using to diagnose of strabismus, the protective plate is a polycarbonate (PC) disc with a thickness of 0.6 mm. The design of this microprismatic element (the diagnostic compensator of strabismus) is completely original and is protected by patents of Ukraine.

Separate prism compensators are combined into special diagnostic sets KK-42, that are widely used today in Ukraine and other countries for determine the angle of strabismus or in the bar of compensators DNSK-1, that are especially convenient for the diagnosis of little children.

 

 

In the case applying IIR microprisms in medical glasses, the protective plate is the refractive lens of the glasses itself. Microprismatic relief will never be in contact with the environment, thereby relief is not contaminated and the optical properties of such combined prism-sphero-cylindrical lenses are stable for even very long-term use. Today IIR microprisms are widely used for the diagnosis and treatment of children's strabismus in Ukraine, China, Uzbekistan.

The application of therapeutic treatment with microprisms should be started at the early age when binocular vision of child is formed, in this case, the effect will get maximal value.

If the therapeutic treatment of strabismus does not produce results, the children are given surgical treatment. Surgeries for strabismus are also performed by adults, that for one reason or other, have not received treatment in childhood or received it as a result of injury. The type of operation is determined by the operating surgeon directly on the operating table, since such an operation must take into account the particular location of the six motor muscles in a particular patient. Sometimes both eyes are operated at once, in some types of strabismus only one eye is operated. An operative intervention is intended to strengthen or weaken one of the muscles that move the eyeball.

 

Surgery for strabismus is performed on an outpatient basis. The position of the eye should be be correct at the very next day after surgery,. In the postoperative period (no more than 2 weeks) eye drops should be instilled and excessive physical exertion should be avoided. Surgery for strabismus allows you to get rid of its clinical presentations. But it will not necessary return perfect eyesight. Every eye in a person with normal vision receives slightly different images that the brain combines into one. In order to get one integreted picture only the gurgery is not enough. Therefore, to restore the binocular vision, in that the two images obtained by the eyes, the brain combines into one, constant exercises are still necessary, including exercises with prisms.

 

Cosmetic effect is also a very important result of surgical procedure. Most people with squint get permanent psychological trauma due to their unusual appearance. The operation allows the person to return the usual appearance and this solves many problems, including social ones.

 

Thus, Fresnel microprisms are widely used in strabismus today, both for therapeutic treatment and together with surgical procedure. Before surgery, prisms are used to generate and strengthen a bifoveal fusion, and after operations, microprisms are used to generate a stable fusion. There prisms are the most effective and painless way to restore solid vision with the therapeutic treatment of strabismus.

 

 

Amblyopia

Amblyopia is a visual defect when a physically normal eye is not involved in the formation of binocular vision. Therefore, this disease is often called the "lazy eye." The following types of amblyopia can be distinguished: refractive, dysbinocular, obscuration, hysterical.

 

The cause of refractive amblyopia is a long and constant projection on the retina of an obscure image of objects of the external environment with high farsightedness and astigmatism effects. This type of amblyopia occurs due to refractive errors, but properly chosen glasses help to gradually increase eyesight quality, even up to a normal level.

 

Disbinocular amblyopia develops as a result of a disorder of binocular vision. Lowering central vision leads to a breakdown of visual fixation and the appearance of off-center fixation. Amblyopia of this type is usually one-sided. With central fixation, timely treatment leads to an increase in visual acuity (with fixation noncentral it is not always possible).

 

The reason for abcurrent amblyopia is congenital or acquired crystalline lens opacity (cataract). Visual impairment will have not only functional, but also anatomical reasons, therefore, a significant improvement in vision cannot be expected.

 

The hysterical form of amblyopia is a rare one and can occur after psychic trauma. There is a decrease in the acuity of central vision, a narrowing of the field of view, spasm of accommodation and convergence. The leading role in this type of amblyopia treatment belongs to the psychotherapist.

Amblyopia is one of the main causes of visual impairment of the children, and accounts for 1.6–3.6% of the total population. It is very important to begin treatment in the early stages of the disease, because in the first few years we got development of our vision. If you do not treat amblyopia of a child during the first 6–10 years, the vision will irreversibly deteriorate and cannot be restored in the future.

 

 

Dictionary of basic terms in ophthalmology

The accommodation of the eye is the process of changing the refractive power of the eye during the visual perception of objects at different distances from it.

Amblyopia is impaired vision, the reason of which cannot be determined by objective examination of the eye.

Binocular vision is a process which includes participation of the both eyes at the same time, thereby obtained images are merged into one, corresponding to the observed object, which ensures the volumetric (stereoscopic) perception of the observed objects.

 

Nearsightedness (myopia) is one of the types of the eye refraction, violation of the refractive ability of the eye (parallel rays of light, refracted in the eye, are focuced in front of the retina, a blurry image is formed on it and objects are not clearly distinguished).

 

Far-sightedness (hyperopia)  is one of the types of the eye refraction. In the case of the far-sightedness the rays coming from distant objects are not sufficiently refracted by the medium of the eye and are focuced behind the retina, where blurry image is formed.

Refraction is the refractive ability of the eye.

The accommodation of the eye is the process of changing the eyey refractive power during the visual perception of objects at different distances.

Amblyopia is impaired vision, the cause of that cannot be determined by objective examination of the eye.

Binocular vision is a seeing in that both eyes participate; at the same time, the obtained images are merged into one, corresponding to objects being examined, that ensures the volumetric (stereoscopic) perception of the observed objects.

 

Myopia (myopia) is one of the types of refraction of the eye - violation of the refractive ability of the eye (parallel rays of light, refracted in the eye, are connected in front of the retina, a blurry image is formed on it and objects are not clearly distinguished).

 

Hyperopia (hyperopia) is one type of eye refraction. The rays coming from distant objects, with farsightedness, are not sufficiently refracted by the medium of the eye, and are connected behind the retina, on which an obscure image is formed.

Refraction is the refractive ability of the eye.