Chapter 4: What are the Signs and Symptoms of Strabismus?
A Patient & Parent Guide to Strabismus Surgery
George R. Beauchamp, M.D.
Signs of strabismus are those aspects that may be observed by the affected individual, parents or others.
These include the misalignment itself (crossing, drifting, etc.), squinting of one eye closed, sometimes rubbing of one or both eyes, and a compensatory head posture.
Symptoms are the feelings or subjective observations of the affected individual.
There may be no symptoms whatsoever, especially in young children or in persons whose strabismus is long standing. If there are symptoms, these may include double vision (diplopia, or two images seen for one object) or ―split‖ vision (like seeing 1+1/2 images), unstable images, eyestrain or fatigue, headache and an awareness that an eye is moving about; it may feel as if one is ―crossing‖ the eyes, yet the preferred eye feels fine. Importantly, there can be other sensations that are unpleasant relating to the affected persons sensitivity to their condition. These include the awareness that they are different and that others treat them differently as a consequence. This may affect one’s self-image and confidence. Some experience difficulties in a variety of areas including activities of daily living, such as reading and driving; work-related activities, including effectiveness, hiring and advancement; social interactions, including ability to communicate; and personal relationships and interactions, including the ability to maintain eye contact that may lead to embarrassment.
Control Deviation of the Eyes
In certain forms of strabismus, it is possible to control deviation of the eyes by positioning the head, called a compensatory head posture. The head may be turned from side to side, chin up or down, or tilted to right or left. Such head postures may be also effected to control nystagmus (shaking or dancing eyes), or to compensate for large refractive errors (that is, the need for eye glasses). Long standing abnormal head positions may lead to arthritic and other changes in the bones and muscles of the neck and spine.
Deciding on Surgery
Only the persons affected and/or their families, in consultation with their doctor(s), can determine the degree to which such signs and symptoms are sufficient to consider strabismus surgery. Doctors can help with information, the perspectives of existing knowledge, experience and then provide recommendations. The remainder of this booklet will provide additional information about the experience of strabismus surgery, so that children and adults with strabismus—and their families—will have additional information to make decisions about care.
Read Chapter 5: Why is Strabismus Surgery Performed?
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