Therapy of Concomitant Strabismus

Therapy of concomitant strabismus in children: Treatment is generally long-term. The duration of treatment may extend from the first months of life to about the age of twelve. Specific treatments and therapeutic success are determined not only by the clinical course but also by the child's overall personality and the parents' ability to cooperate. The entire course of treatment may be divided into three phases with corresponding interim goals.

1. The ophthalmologist determines whether the cause of the strabismus may be treated with eyeglasses (such as hyperopia).

2. If the strabismus cannot be fully corrected with eyeglasses, the next step in treatment (parallel to prescribing eyeglasses) is to minimize the risk of amblyopia by occlusion therapy.

3. Once the occlusion therapy has produced sufficient visual acuity in both eyes, the alignment of one or both eyes is corrected by surgery. Late strabismus with normal sensory development is an exception to this rule (for further information, see Surgery). The alignment correction is required for normal binocular vision and has the added benefit of cosmetic improvement.

Therapy of concomitant strabismus in adults: The only purpose of surgery is cosmetic improvement. A functional improvement in binocular vision can no longer be achieved.

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