Strabismus in Children
Diagnosis and treatment of strabismus in children at the Indian Eye Institute and Laser Center in Tirana. The clinic treats horizontal, vertical, and paralytic strabismus, as well as cases associated with nystagmus or double vision, using modern methods tailored to each child.
What Is Strabismus in Children?
Strabismus is a condition in which the eyes do not look at the same object at the same time. One eye may turn inward, outward, upward, or downward.
The misalignment may be constant or occur only at certain times. It may always affect the same eye or alternate between the two eyes.
When the eyes do not work together properly, the development of binocular vision and stereopsis, or three-dimensional vision, may be affected. The child may also develop amblyopia, commonly known as “lazy eye.”
The Indian Eye Institute and Laser Center performs procedures for various types of strabismus in children and adults. The clinic also performs tear duct opening procedures in children under brief general anesthesia.
STRABISMUS IN CHILDREN AT A GLANCE
Duration:
Recovery:
Examination:
Clinical experience:
PHOTO GALLERY
Moments with Our Patients
What Signs May Indicate Strabismus in Children?
Strabismus may be noticeable all the time or only when the child is tired, unwell, or focusing at a particular distance.
Inward or Outward Eye Deviation
Vertical Eye Deviation
Abnormal Head Position
Closing One Eye
Double Vision
Involuntary Eye Movements
Strabismus in Children: Diagnosis and Treatment
The examination is tailored to the child’s age, ability to cooperate, and type of strabismus. The aim is to assess vision in each eye, eye alignment, and how well the eyes work together.
Age-Appropriate Examination
For infants, special cards with patterns of different sizes are used. The doctor assesses which images attract the infant’s attention and compares the result with the expected values for their age.
For children aged 3 to 5, Lea symbols are used. Their ability to recognize the symbols is assessed at both near and far distances.
For children over the age of 6, charts with letters or symbols similar to those used for adults may be used. In every case, visual acuity is assessed separately for each eye.
Orthoptic Assessment and Binocular Vision
The orthoptic assessment evaluates eye alignment, motility, and coordination. The type of strabismus is identified, and the angle of deviation is measured with prisms at near and far distances and in different directions of gaze.
The movements of each eye and the coordinated movement of both eyes are assessed. Convergence, divergence, and the ability to shift focus are also evaluated.
Binocular vision and stereopsis are assessed using tests such as Titmus, Lang, and Bagolini. The examination also checks for amblyopia, nystagmus, and double vision.
Objective Refraction and Pupil Dilation
Children have a strong ability to accommodate, which can mask a higher refractive error. For this reason, eye drops are used to dilate the pupils and temporarily relax the focusing mechanism.
Once the pupils are dilated, retinoscopy is performed to determine the objective refractive error. Vision may remain blurred for several hours or up to a day after the examination.
The Plusoptix pediatric autorefractor is used for infants, young children, and patients with special needs. The device measures refractive error, pupil size, and the corneal reflex from a distance of approximately one meter while the child looks at the camera for less than a second.
The examination is completed with an assessment of the front of the eye, the retina, and the optic nerve.
Benefits of Strabismus Treatment
Treatment aims to improve eye alignment and support visual development. The outcome depends on the type of strabismus, the child’s age, and any associated vision problems.
Improved Eye Alignment
Coordination Between the Eyes
Support for Three-Dimensional Vision
Reduced Abnormal Head Position
Age-Appropriate Treatment
Personalized Treatments for Strabismus in Children
Optical and Amblyopia Treatment
Not every child with strabismus requires immediate surgery. Initial treatment is determined by the refractive error, vision in each eye, and type of deviation.
- Glasses with the Appropriate Prescription
- Patching the Stronger Eye
- Eye Drops for Amblyopia Treatment
- Regular Orthoptic Monitoring
Strabismus Surgery
Surgery targets the muscles that control eye movement. Certain muscles may be weakened, strengthened, or repositioned to improve eye alignment.
- Horizontal Strabismus
- Vertical Strabismus
- Paralytic Strabismus
- Cases Involving Nystagmus or Double Vision
Pediatric Tear Duct Procedures
In children with a blocked tear duct, the duct can be opened under brief general anesthesia. The procedure is planned after examining the child.
- Assessment of tear drainage
- Opening of the blocked tear duct
- Short-duration general anesthesia
- Post-procedure follow-up visits
What to Expect
01. Comprehensive Eye Examination
The child’s examination takes approximately two hours and includes an assessment of near and distance vision, measurement of the deviation, and stereopsis testing.
The method used to measure vision is adapted to the child’s age. Special cards are used for infants, Lea symbols for young children, and letter charts for older children.
The angle of strabismus is measured using prisms, and the movements of each eye and both eyes together are assessed. When necessary, tests are performed for amblyopia, nystagmus, and double vision.
Dilating eye drops are used to determine the objective refractive error and examine the retina and optic nerve. Parents should prepare their child for the application of the drops and the temporary blurred vision that follows.
02. Procedure
Strabismus surgery in children is performed under general anesthesia. The child must follow the fasting instructions for food and fluids before the procedure and complete the required tests.
Before the procedure, the anesthesiologist discusses the child’s general health, medical history, and laboratory results with the parents.
During surgery, the position or strength of the muscles that move the eyes is adjusted. The surgical plan is based on the type and angle of strabismus and may involve one or both eyes.
After the procedure, one parent may stay with the child during recovery. Depending on the procedure, the child may be discharged after a few hours or remain at the clinic overnight.
03. Recovery and Follow-Up
Depending on the type of procedure, a patch may be placed over the operated eye. Parents should ensure that the child does not remove the patch or rub the eye.
The eye drops must be used for the period prescribed by the doctor. Following the treatment instructions correctly is essential for the eye to heal.
The first follow-up visit usually takes place one day after the procedure. Further follow-up visits are scheduled according to the procedure, typically one or two weeks later.
Redness and mild discomfort may occur after surgery. Severe pain, worsening swelling, discharge, or a sudden decrease in vision require immediate contact with the clinic.
Indian Eye Clinic Tirana: 15+ Years of Trust
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Every successful treatment begins with an accurate diagnosis and a personalized care plan. Discover the real stories of patients who trust Indian Eye Institute and Laser Center.
I have advanced glaucoma in both eyes and have undergone glaucoma and cataract surgery with Dr. Taneja. I have been receiving regular follow-up care from Dr. Taneja for the past 11 years.
I am very happy and satisfied with my experiences at Dr. Taneja’s clinic. The staff are helpful, knowledgeable, competent, and very pleasant. Dr. Taneja has worked diligently to preserve my vision, and I am extremely pleased with the care I have received. He deserves recognition for how good he is at what he does. I would recommend him 100% to anyone with serious eye problems.
I have suffered from a long-term problem with floaters in both eyes. Dr. Nishant Taneja is truly an expert in his field who allows patients to consider nonsurgical options as the first course of treatment. He is professional and courteous, treats patients with respect, and communicates clearly in terms that ordinary people can understand. I believe he is honest and straightforward, and he is taking excellent care of me.
I have been a patient of Dr. Nishant Taneja since 2010, when I was diagnosed with wet macular degeneration. He has treated me with Avastin, Eylea, and now brolucizumab, and I can still read large print.
I owe my sight to his treatments. He has taken excellent care of my eyes. The staff are absolutely outstanding in their courtesy and professionalism. I am 93 years old and can still read clearly. Thank you!
When I first came here, I thought I would go blind in my left eye. I was diagnosed with a vitreous hemorrhage caused by detachment of the vitreous gel. After the laser treatment, my vision returned to what it had been before.
I have received excellent medical care here. The entire staff have been very kind and have made everything much easier for me. I am very happy.
Many thanks to the entire staff. The whole process of my cataract surgery and the care I received were the best I have ever experienced at any medical practice. The staff and technology were first-rate. Dr. Taneja is simply phenomenal. Thank you again.
I underwent surgery for a retinal detachment last week. I experienced no pain during or after the operation. I slept well the following night without needing any pain medication. If anyone has questions about retinal surgery, please feel free to call me.
I am impressed by the high standard of patient care I received from Dr. Taneja at the Indian Eye Institute. I hold him in the highest regard.
I have had diabetes for over 30 years. Over the past 5 years, my vision gradually deteriorated. I had been receiving treatment from my ophthalmologist for the previous 4 years. The treatment involved injections, but the situation seemed to be getting worse. I could barely see well enough to drive, could not read anything on my phone, and began having difficulty recognizing people from a distance. I therefore decided to visit Dr. Nishant Taneja on the recommendation of my eye doctor. He was prompt, efficient, and professional. Within minutes, he had mapped out a treatment plan for both of my eyes and advised me to follow it. I was truly impressed by his energy, optimism, and confidence.
After several injections and laser treatments, he said that I needed a vitrectomy in my left eye. It went perfectly, without any complications. My vision in that eye was restored to 20/20. I felt as though I were opening my eyes for the first time.
After I recovered from that procedure, Dr. Taneja said that my right eye also needed surgery. So, without hesitation, I had that eye treated as well. I now have 20/20 vision in both eyes, and everything is wonderful.
I can now see my two young grandchildren clearly. This has improved my quality of life tremendously. Without a doubt, I am probably the happiest patient Dr. Taneja has ever had!
I am delighted to express my appreciation for Dr. Taneja and his exceptional staff.
If you are reading this review while deciding on a retina specialist, you have definitely come to the right place! An excellent doctor and staff. I am more than completely satisfied!
I believe Dr. Taneja is an exceptionally talented surgeon.
I began wearing glasses and contact lenses at the age of 12. I relied on them to see and read. During the spring, pollen irritated my eyes, and I could no longer wear my contact lenses.
After the procedures performed by Dr. Taneja, I went from being unable to see to having clear vision without contact lenses or glasses.
I would recommend Dr. Nishant Taneja for any procedure he performs. He is highly meticulous, compassionate, and understanding.
He worked a miracle for me. I thank God for his talent.
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Frequently Asked Questions
The surgery is performed under general anesthesia, so the child is asleep and feels no pain during the procedure. After surgery, the child may experience redness, a scratchy sensation, or mild discomfort.
Surgery improves eye alignment but does not directly treat amblyopia. The child may still need glasses, patching of the stronger eye, or eye drops.
Yes. After surgery, one parent may stay in the room with the child during recovery. The length of the clinic stay depends on the type of procedure.
The first checkup is usually performed one day after surgery. Additional visits are scheduled based on the child’s recovery, usually one or two weeks later.
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