10 yr old with strabismus

My daughter, who is now 10 yrs old,  was diagnosed with strabismus when she was about 2, but I saw this soon after she was born.  Her right eye goes inward alot.  She is also extremely far or near sighted (I can't remember which one).  She does see an M.D. for this and has had many lens changes.  I did ask if surgery would be an option down the road for her and was told that it depended on what kind she had.  That they usually wait to see if things are able to get somewhat better after all the stages the eyes go through in early childhood.  At what age is it appropriate to have surgery done?  From what I'm reading, it sounds like the surgery isn't always a success and may take several.  Is it better to just have her consider contacts in the very near future?  I didn't realize that there were doctors who specialized in strabismus solely, is this true?  Will my daughter end up with bad vision problems when she is older?  What I guess I'm really wanting to find out is,  what is her vision outlook for the future with this?   I am just starting my research into this and appreciate any help you can give me.  Thanks.

[John C Hagan III, MD, FACS, FAAO]

In eye muscle problems especially crossed eyes (esotrophia) the cause is almost always farsighted (hyperopic) rather than myopic (near sighted).

Surgery is NOT a substitute for glasses and surgery is only done if glasses do NOT correct the problem. Eye muscle surgery would not make the eye less farsighted and get the child out of the glasses.

At some point when she's older, more mature and if she doesn't like glasses she will probably be a good candidate for contacts. If she wears bifocals then special contacts or reading glasses may also be necessary.

Her brothers, sisters, cousins and her children will have a 20% chance of having the same problem so everyone related by blood that has small children should have them check by an Eye MD ophthalmologist by age 3 at the latest and immediately if crossing or abnormalities are seen.

Many Eye MDs ophthalmologists treat strabismus. There are pediatric ophthalmologists that only do strabismus (eye muscle problem).

JCH III MD

[abby29]

i would suggest you to make an action for that.. dont go for something that is temporary.. go for the permanent solution.. specially, its a DAUGHTER, insecurities will arise when she gets older, coz that is what im feeling that is why i decided to undergo operation.. when she removes her contacts, what will happen..? its just the same.. go for the permanent solution.. my doctor gave options, wear a pirsm or undergo surgery and, i just underwent surgery because i have strabismus, a manifest esotropia.. but in my case, my doctor is requiring me for a second operation.. children are easier to be treated than adult, that is what my doctor told me.. God bless!

[suzieq321]

Thank you for your response.  I forgot to tell you that she was born a preemie and have heard that it is a factor with them having vision problems.  I have also since found out what diagnosis they have given to her:   Esotropia Accomodative and Amblyopia unspecified and pseudostrabismus/epicanth fold.  Kind of understand what those mean.  Does this change your opinion that my daughter shouldn't consider surgery since glasses do correct her vision?  She hates that the lenses make her eyes look so big and that they are thick.  The Opthalmologist she sees doesn't specialize in this area.  He mainly deals with glaucoma, LASIK surgery, etc...    Is this a sign that I should find someone who does pediatrics and specializes in the type of things my daughter needs?
Once again, thank you very much for your time - it is greatly appreciated!

[suzieq321]

Thank you for your response.  I am in the midst of trying to find out if surgery may help her in the near future and totally understand the insecurities that come from this problem.  My daughter has started really not liking that the lenses are so thick that it makes her eyes look big.  She has always had this problem, so the kids don't really say anything to her (but she does wear her glasses almost always).    At least nowadays they don't make fun of children with glasses like they used too.  My daughter also has a unique situation; she has two different colored eyes.  I will keep in mind your suggestions and appreciate your taking time to help me get things sorted out.

[John C Hagan III, MD, FACS, FAAO]

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