Types of strabismus

Types of strabismus

Strabismus, or scientifically strabismus, is not always a congenital pathology, it can appear at any age. Let’s figure out what strabismus is, and what provokes this violation.

The cause of congenital strabismus is the pathology of the development of the organs of vision. Abnormalities of the retina, optic nerve, and visual regions of the brain can all affect the position of the eyes. Improper structure and attachment of the outer eye muscles also cause one or both eyes to squint.

Slight asymmetry in newborns is not always a cause for concern, as their visual system is still developing. Parents notice the asymmetrical movement of the baby’s eyes after six months, when normal vision is established in children. But an ophthalmologist detects a violation at an earlier age, so you should not ignore the examination of a pediatric ophthalmologist. 

Usually, the visual defect manifests itself up to 3 years, but sometimes strabismus appears later as a result of myopia, hyperopia and astigmatism. If the eye does not focus on the retina, the image becomes blurry. Converging or diverging strabismus may occur. If the refractive errors in the eyes are not the same, then the eye, which perceives the image less clearly, will squint more often and harder. Of course, strabismus does not occur in all children with poor eyesight. Severe stress or an inflammatory disease will desynchronize the work of the visual system.

In adults, in addition to stress and inflammation, strabismus is triggered by high visual load and traumatic brain injury.

Types of strabismus

  • Strabismus can be permanent or intermittent.
  • Depending on the direction of the deviation of the eye, doctors classify strabismus:
  • Converging or exotropia when the eye is directed towards the bridge of the nose. Farsightedness usually accompanies.
  • Diverging (esotropia) when the eye is directed to the temple. This condition is typical for myopia. 
  • Vertical: the eyeball deviates up or down.


Based on the cause of the occurrence, friendly and paralytic strabismus is distinguished.

If both eyes constantly or alternately deviate from the center, and usually at the same angle, they speak of concomitant strabismus. The most common cause is a violation of refraction, characteristic of myopia, hyperopia and astigmatism. If one eye sees much worse than the other, the brain tries to compensate for this difference, which also disrupts the synchronous movement of the eyes.   

Concomitant strabismus is:

  • accommodative, depending on the ability of the eye to focus the image on the retina at different distances;
  • partially accommodative;
  • non-accommodating.

To restore the correct position of the eyeballs with friendly accommodative strabismus, glasses and apparatus therapy are usually sufficient.

  • With paralytic strabismus, only one eye deviates, which remains practically motionless. This is due to paresis of muscles or nerves, congenital or appearing after an illness, under the influence of a tumor. In addition to visual impairment, a person suffers from dizziness, double vision.
  • If only one eye deviates at a time, the person has monocular strabismus.
  • When alternating, it squints one or the other eye.

Why is squint dangerous?

It is not worth hoping that the defect will go away on its own, although this happens in newborns. If untreated, the deviation becomes more pronounced, leading to deterioration of vision, double vision, dizziness.

The brain receives a different image from the right and left eyes and excludes the “erroneous” source of visual information. This is how amblyopia develops when one eye is not involved in the visual process. 

Strabismus detected at an early age lends itself to non-operative treatment: with the help of optical correction or devices. Exercises on special devices strengthen the eye muscles, improve their coordination. Ophthalmologists of the Eye Microsurgery Clinic on Maerchak make up the optimal course of apparatus therapy for each patient. At the same time, doctors are guided by the type of deviation, the underlying disease, and take into account the physiology of the eye.  

In adults, eye surgery is usually ineffective. In this case, an operation helps, during which the doctor weakens some muscles and strengthens others, aligning the position of the eye. As a result, the patient gets rid of the external defect and gains good vision. 

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