With hidden strabismus (heterophory), the eyeballs deviate from the anatomically normal position due to an imbalance in the work of the motor muscles. The disease occurs mainly in children. In this case, vision remains stably high, and binocularity is maintained, so it is almost impossible to determine the heterophory itself. Latent strabismus is not a dangerous ophthalmic disease, but can subsequently lead to serious complications if appropriate measures are not taken in time.
General classification
Normally, the eyeballs work in sync so that the gaze focuses on the selected object. If deviation is observed, then heterophory is diagnosed. The shape of strabismus can be hidden, vertical, diverging, mixed, paralytic or friendly. A defect can occur both permanently and temporarily. Atypical strabismus is also distinguished (with cerebral palsy or Down syndrome). There may be mixed forms, such as hidden divergent strabismus.
Causes of the disorder
Latent strabismus in children is diagnosed quite often. Babies of the first year of life almost always have deviations of the visual axis, but by six to twelve months these problems disappear. The eye muscles of the newborn are weakened, only by the fourth month the activity reaches the norm, so that simultaneous control of the eyeballs is possible. The main factors provoking latent strabismus in childhood are prematurity, genetic pathologies or adverse heredity, Down syndrome, hydrocephalus (a severe pathology that affects brain tissue), and the mother's use of drugs, alcohol and certain drugs during pregnancy.
The causes of latent strabismus in adults can be various head injuries, neurological disorders, paralysis, inflammatory ophthalmic diseases, abnormal development of the visual organ, decreased visual acuity, endocrine disorders, significant physical exertion, cataracts and other pathologies of the organs of vision. Heterophoria can be a consequence of thyroid disease, paralysis of the eye muscles, nearsightedness or farsightedness, which causes overstrain of some muscles and weakness of others.
Manifestations of strabismus
Latent strabismus in adults can be manifested by the following symptoms: difficulties in focusing the gaze on one subject, periodic restriction of pupil mobility, increased fatigue, nausea, and deviation of the pupils in different directions. To detect strabismus, it is enough to block the possibility of binocular vision. To do this, close one eye. In this case, he deviates in the direction that corresponds to the type of heterophory. When binocularity is restored, the pupil will make a characteristic movement and return to the correct position. In the absence of strabismus, the eyeballs will remain in a consistent position.
Diagnostic Methods
For the diagnosis of latent strabismus in medical practice, methods are used that exclude one eye from the visual process. The easiest way to diagnose is to focus on a specific object in turn of each eye. The ophthalmologist will follow the work of the eyes, and if there is a difference in the speed and accuracy of the movement of the pupils, then we can talk about hidden strabismus. In children, it is more difficult to identify the deviation, because not all kids are able to fulfill the doctor’s commands. In this case, resort to hardware diagnostics or offer color pictures.
To determine concomitant diseases, an assessment of vision is carried out using the appropriate tables. Adults are offered the Sivtsev table, and children are offered Orlova. As measures of additional diagnostics, the state of blood vessels, the magnitude of the visual fields are evaluated, electrophysiological tests are prescribed. This is a reliable way to help determine the strabismus angle accurately.
Treatment for latent strabismus is based on methods of strengthening muscles and restoring vision. Usually the patient does not have problems with visual acuity, so radical methods are rarely used. To eliminate strabismus, children are shown wearing corrective glasses. In the presence of other vision problems, appropriate lenses are selected. Heterophoria can be acquired or congenital, but latent strabismus is rarely acquired. In any case, the treatment should eliminate the provoking factors.
Correction options
How to hide strabismus? Typically, glasses and lenses, surgical treatment, exercises with the help of special devices, occlusive dressings are used for correction. After surgery, therapy does not end. The doctor will prescribe drops and procedures for further correction of the defect. Glasses and lenses are indicated for patients with any form of strabismus. Often this is the best method for patients with other ophthalmic disorders.
Glasses completely correct hidden strabismus, especially if you start treatment in childhood. But many ophthalmologists note that treatment to achieve the best effect should only be comprehensive. Otherwise strabismus will remain. When points are assigned that hide strabismus, control checks will need to be held every two months.
It is believed that strabismus should not wear lenses. But this method of correction differs from traditional glasses only in location. Lenses have both positive and negative sides. Modern soft contact lenses can be worn continuously without compromising vision. In any case, the doctor should decide on the choice of the correction method based on the indications and wishes of the patient. It is possible to hide strabismus with lenses, but not all forms of pathology make it possible to do this equally effectively.
Surgical intervention is indicated only if traditional methods do not give the desired effect. During surgery, the eye muscles are shortened or lengthened to hide the defect. Points with hidden strabismus after surgery will no longer be needed.
Synoptofore exercises
Orthopo-diploptic treatment consists in eliminating the disorder with the help of special devices on which a person performs exercises to improve vision. During exercises, there is simultaneous or sequential irritation of the retinal fossae, which leads to synchronization of the patient’s eyes. The procedure is as follows. A round test (diameter is 7 cm) is placed in a special device, on which there is a horizontal mark (5 mm). The patient’s head is placed on a stand. The test eye is closed. Next, the patient looks at the test so that the image is projected onto the retina. Within twenty seconds, irritation of the posterior pole of the eye occurs. The purpose of this procedure is to achieve stable binocular vision.
Occlusive dressing
The essence of using the dressing is that a healthy eye closes. This is necessary so that the eye, whose activity is impaired, is also included in active work. Often a bandage is fixed under the glasses. The wearing period is individual, determined by the ophthalmologist, but you need to know that you can not close one eye with occlusion for more than fourteen days. You need to change the bandage every day.
Unconventional methods
There are many popular methods of treating latent strabismus, but not all of them give a lasting positive result. Regarding the use of recipes of alternative medicine, it is worth consulting with your doctor. It is believed that the use of calamus decoction has a positive effect on the eye muscles. To prepare a healing drink, you need 5-10 grams of a dry plant, pour hot water and pass through a sieve. You need to drink the broth four times a day before meals.
Useful cabbage. To prepare the medicine, pour cabbage leaves with cold water and cook until the vegetable has completely decomposed. Eat daily. You can brew rose hips. The broth should be allowed to infuse. Consume thirty minutes before meals. Often used for the correction of ophthalmic diseases needles of pine and spruce. Needles need to be brewed with boiling water and let it brew. Drink on an empty stomach before breakfast.
Before using any folk remedy for the treatment of latent strabismus, you need to make sure that there are no contraindications. Be sure to consult a doctor who will help you choose the most effective method of therapy. The selected remedy needs to be treated constantly. You can not use one method at first, and after two days move on to the next. The course should be at least two weeks. Folk remedies should be used without fanaticism, without abandoning the traditional treatment.
Gymnastics for the eyes
Gymnastics is no less effective with hidden strabismus. Perform a set of special exercises every day. Adults are offered the following set of exercises:
- Relax your eyes, focus your eyes on one point (subject), and then try to combine the pictures that each eye sees separately. The exercise can be considered successful if the pictures are combined.
- You need to stretch your arms forward and focus your eyes on the index finger. The finger is slowly brought closer to the bridge of the nose, without taking his eyes off. Repeat 15-20 times.
- Look out the window, select the farthest point, and then look at an object that is close. Repeat 5-10 times.
- Outline different shapes in the air: numbers, square, zigzags, letters, eights.
It is difficult for young children to concentrate on one lesson for more than fifteen minutes. Experts recommend dividing the complex into several approaches that can be performed during the day. It is necessary to divide a large sheet of paper into squares, in each of which draw different pictures. The kid should be asked to show the same image.
Another exercise is to put the child at the table. Install the lamp with a frosted lamp. The distance from the light source to the child's face should be at least 40-45 cm. You need to close one eye (it is better to use a bandage) and turn on the lamp. In five to ten centimeters from the light source, fix the plasticine ball. The child should watch the ball for thirty seconds, trying not to blink. The child should see a dark circle with a white base. This is called a sequential image. Then you need to show the baby pictures until the image disappears. During the exercise, the child should not be sleepy or tired.
To treat or not to treat?
In the absence of complaints, strabismus is not treated. But if such a condition is caused by refractive errors, correction or laser surgery is necessary (if indicated). Generally, wearing special glasses or lenses solves this problem. Hardware treatment allows you to restore muscle activity and optimize the ability of the eye muscles to merge images.
Strabismus Prevention
Adults need to be protected from injuries and infections, and also visit an ophthalmologist regularly (especially if there are vision problems). It is strictly forbidden to read in vehicles, overload your eyes, self-medicate. Every day you need to do gymnastics for the eyes, avoid stressful situations and include moderate physical activity in your life. Especially useful are swimming, jogging or tennis.
Children from an early age need to hang all toys on an outstretched arm. The TV is allowed from three years, while the distance from the device should be at least 2-6 meters. The computer can be used from 8 years, but not more than 30 minutes a day. It is necessary to provide the child with proper and proper nutrition, to give to the sports section. Useful tennis, basketball and volleyball. Premature babies should be regularly observed by an ophthalmologist.