What Is Adult Strabismus?
Strabismus is the term used to describe any misalignment of the eyes in which the eyes fail to work in tandem to focus on and track objects correctly. While strabismus is a common pediatric eye condition, it can also affect adults, causing them to experience somewhat different symptoms and impacts compared to younger patients.
With strabismus, when one eye is focused straight ahead, the other eye will turn in, out, up, or down. For adults, this turning can create visual disturbances such as double-vision or visual confusion that can become debilitating. The appearance of the turned eye can also have a negative impact on a person’s emotional wellbeing and social interactions.
Many patients erroneously believe there is nothing that can be done for adult strabismus or that correcting it is a cosmetic procedure not covered by insurance, which is not true. In fact, there are a number of treatment options available for adults with strabismus, and in most cases, insurance carriers will cover strabismus treatment as it is considered medically necessary and not an elective cosmetic procedure (check with your insurance provider for specifics). The fact that strabismus therapy improves a patient’s appearance is secondary to the fact that treatment is undertaken to correct a visual disorder that can be incapacitating.
What Causes Adult Strabismus?
Strabismus occurs when there is an abnormality in the muscles or nerves associated with eye movement or in their connection to the brain. While it is not always possible to identify the origin of strabismus, some common causes of strabismus in adults include:
- Childhood strabismus that was not corrected or has recurred.
- Certain Neurological Conditions
- Thyroid Eye Disease
What Are the Symptoms of Adult Strabismus?
Besides the visible turning of an eye (the classic indicator of strabismus), adults who suffer from strabismus experience additional symptoms. In children with strabismus, the brain typically learns to ignore visual input from the turned eye, which means children tend to experience less direct visual disturbance (although they may develop amblyopia, also known as lazy eye). For adults whose brains are used to receiving visual stimuli from both eyes, strabismus can have different symptoms such as:
- Double-Vision (Diplopia) – Seeing two images of the same object when there should only be one. The images can be distinct or overlap to some degree. Diplopia is a debilitating condition that affects reading, driving, and working.
- Visual Confusion – Seeing two different images superimposed onto each other. This can be debilitating and even dangerous when doing an activity such as driving.
- Image Jump – Images captured in the field of view change significantly as focus shifts from one eye to the other.
- Abnormal Head Posture – Adults with strabismus often turn their face or tilt their head to compensate for double-vision. Over time, the muscles of the neck can shorten and tighten, changing the individual’s normal head posture and range of motion.
How Is Adult Strabismus Diagnosed?
Even when symptoms are prevalent, a comprehensive eye examination is still needed to diagnose adult strabismus. Only with a thorough eye examination by a qualified eye doctor — like those at the Dean McGee Eye Institute — can the type of strabismus be properly diagnosed, possible underlying causes identified, and a course of treatment determined.
Treatments for Adult Strabismus
There are different approaches to treating adult strabismus depending on its cause and severity, but they all have the same goal of restoring binocular vision. Treatment options include:
- The use of a prism in eyeglasses to correct double vision
- Eye exercises (orthoptics)
- Injections of botulinum toxin (Botox)
Adult Strabismus Surgery
If the misalignment cannot be corrected using other methods, surgery might be recommended. During strabismus surgery, the eyelids are held open by a lid speculum and your surgeon gains access to the eye muscles by making a small incision in the conjunctiva, the thin layer of transparent tissue that covers the eye. The eye muscles may be strengthened, weakened, repositioned or otherwise altered depending on your particular needs and the judgment of your surgeon. At no point is the eyeball removed.
Surgery is usually performed on an outpatient basis and most patients return to normal activity in several days.
In some cases, a surgeon will choose to use an adjustable suture technique in which a temporary knot is used. This knot is left accessible so that the surgeon can use it to adjust eye alignment after surgery. Such adjusting is usually done while the patient is awake and can be performed soon after surgery or within a day. The use of adjustable sutures increases the ability of the surgeon to achieve correct alignment and may decrease the need to perform muscle surgery on that eye again in the near future.
For most patients, surgery provides significant improvement in eye alignment. However, some patients may be required to continue other treatment protocols after surgery or may even need additional surgeries to more adequately address their strabismus.
Adult Strabismus Doctors at the Dean McGee Eye Institute
It takes specially-trained physicians to effectively treat adult strabismus. Since strabismus is much more common in children, pediatric ophthalmologists have significant experience in treating it and therefore often treat strabismus in adults as well. In addition, neuro-ophthalmologists, with their expertise in the neuro-muscular systems of the eye, also regularly treat strabismus.
At the Dean McGee Eye Institute, we have a team composed of both types of ophthalmologists — the only practice in the region with such a team.
You do not have to suffer from strabismus in silence. Whatever your age or the severity of your condition, we want to help! Visit our online directory of providers who treat adult strabismus to learn more about our team or call 405.271.6060 or 800.787.9012 to schedule your appointment today. We look forward to serving your vision needs.