Seize the golden period for correcting children's esotropia and correct it! It's better to do it sooner rather than later

Author: Yang Li, Mianyang Third People's Hospital, Sichuan Province

Reviewer: Yang Bi, Associate Professor, West China Hospital, Sichuan University

Three months ago, Tongtong's mother accidentally discovered that the two-year-old Tongtong's eyes seemed a little different from those of normal children, like "opposite" eyes. The mother was very anxious: "The child is so young, and his eyes are like this. Will it have any impact on the future?" The neighbors said that the child was too young and could only undergo surgery when he grew up. After delaying for several months, Tongtong's parents could not hold back their desire to seek medical treatment, and brought the child to the ophthalmology department of the hospital. After careful examination, it was diagnosed as "common strabismus". The ophthalmologist told them that the child could undergo surgery. Strabismus surgery is not only to correct the eye position and improve the appearance, but more importantly to improve vision and re-establish binocular single vision function. For this type of esotropia children, the younger the age of surgery, the better the treatment. When the child's visual development stops, it is difficult to improve binocular vision function.

Following the doctor's advice, Tongtong's parents immediately arranged for her to be admitted to the hospital. After completing relevant examinations and formulating a detailed surgical plan, Tongtong underwent "bilateral medial rectus muscle posterior retraction surgery" under general anesthesia. On the second day after the surgery, Tongtong's eye position returned to normal, and the family finally put their worries to rest.

1. What is strabismus?

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Strabismus is a visual phenomenon in which the optical axis of one eye is tilted when both eyes are looking at a target. It usually manifests as the two eyes not being able to look at the same target at the same time, and may manifest as one eye tilting inward (esotropia), outward (exotropia), upward or downward. This eye problem is more common in children, and if not treated in time, it may have long-term effects on the child's vision, vision, and even facial development symmetry.

2. The harm of strabismus

Impaired binocular vision function: Strabismus will affect the coordination of the two eyes, which may cause one eye to see objects while the other eye's vision is suppressed, leading to amblyopia and affecting the development of binocular vision and stereoscopic vision function.

Amblyopia: If strabismus is not corrected in time, it may lead to amblyopia. Even wearing glasses cannot correct the vision.

Psychological impact: The appearance of strabismus may cause children to be ridiculed at school and socially, affecting their self-esteem and confidence.

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The main treatment methods for strabismus

Treatments for strabismus vary depending on the type, including wearing glasses, patch therapy, vision training, and surgical correction. Among them, surgical correction is the main treatment for mechanical or non-accommodative strabismus. Many parents always want to wait after the doctor recommends surgery, thinking that the child will grow up and get better. In fact, except for a small number of strabismus that can be corrected by wearing glasses, most other strabismus require surgical treatment.

1. The golden time for surgical treatment

According to ophthalmologists, early detection and timely treatment of strabismus are crucial. Generally speaking, the best time to undergo surgery for congenital esotropia is 1 to 1.5 years old, and no more than 2 years old at most.

2.Why is 1 to 1.5 years old the golden period?

Vision development: At this age, children's vision and binocular vision are still developing rapidly. Early correction can maximize the restoration of normal visual function.

Neuroplasticity: The nervous system is highly plastic, and early surgery can better restore visual function and binocular coordination.

Less psychological impact: Younger children are more accepting of surgery and treatment and have relatively less psychological burden.

3. Is strabismus surgery safe?

Strabismus surgery is a routine ophthalmic surgery with a mature method. Strabismus surgery does not touch the inside of the eyeball, but makes an incision at the "white of the eye" (sclera). By adjusting the position and tightness of the extraocular muscles on the surface of the eyeball, strengthening or weakening the strength of the related muscles, the muscle strength is rebalanced, and the child's eyes can be kept "seeing together" without affecting the child's vision.

Generally speaking, strabismus surgery will not damage the internal structure of the eyeball, nor will it cause vision loss. It is relatively safe to be performed by professional doctors in regular hospitals. Moreover, strabismus surgery nowadays has a short treatment time, small incision, mild postoperative reaction, and no need to remove stitches, so most of them have good results.

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IV. Conclusion

Although strabismus is common, it is not incurable. Early detection and timely treatment are the key. Parents should pay attention to their children's eye health and have regular eye examinations. Once discovered, scientific treatment measures should be taken in a timely manner to maximize the child's visual and mental health. Through hard work, every child can have a clear and bright future.