Correcting Strabismus

5-20% of children have eyesight problems, 5% of children have strabismus

Beneficiaries

Surgical Interventions

Pairs of Glasses

About Strabismus

Strabismus is an eye condition in which the axes of the two eyes are not parallel and one or both eyes deviate.

What are the signs of strabismus?

The main sign is the lack of alignment of the visual axes of the eyes, ie an eye moves away from, or is constantly out of the normal parallel or straight ahead position. At other times, there are indirect signs such as closing one eye in bright light, turning or tilting the head to one side.

What are the causes of strabismus?

The causes of strabismus are various:

  • Heredity: one of both parents have strabismus, (also apparent when siblings or close relatives have strabismus, but it can also occur in children when no relatives have strabismus);
  • Refractive deficiencies, especially when there are different diopters in the left or the right eyes. Often, refractive problems are inherited;
  • Impaired vision for various reasons (lesions on the fundus of the eyes, cataracts, intraocular tumors);
  • Premature birth or immature development;
  • Neurological disorders: hydrocephalus, Down syndrome, cerebral palsy;
  • Congenital orbital or eye disorders;
  • Brain, orbital or eye injuries;
  • Unknown causes: most of the time the cause cannot be established. Strabismus can occur in children without other associated conditions.

Once the strabismus is found, the child should be checked IMMEDIATELY by a pediatric ophthalmologist.

The first urgency is the detection and treatment of amblyopia, i.e poor eyesight. If one of the eyes deviates more frequently, his vision may decrease through non-use. The right eye is mostly used. Amblyopia occurs in 40% of children with strabismus and is the leading cause of vision loss in the eyes of the people aged 20-70. It can be prevented by eye surgery.

The second major problem is the lack of binocular vision, which also includes stereoscopy, “3 D” vision. The lack of binocular vision implies the incorrect appreciation of distances, practically and extremely bothersome, especially for driving as well as for sports or practicing trades that require depth perception such as working at heights, architecture, painting, surgery, etc. Many children with strabismus have a poor development of motility and balance of the whole body.

Congenital strabismus

When the onset of strabismus occurs under the age of 6 months, it is called congenital strabismus. Convergent strabismus, when the eye diverges towards the nose, is the most common form.

The earlier the strabismus appears, the quicker it must be attended to, otherwise the chances of recovering the sight of the weak eye and the binocular vision decrease.

The purpose of the initial examination is to determine the cause of the strabismus and to decide on the type of treatment required.

Ophthalmic treatment in strabismus

Strabismus can be treated successfully, the treatment being adapted to each patient, depending on the type of strabismus, age, the association of vertical and horizontal deviations, if they have been operated on before.

Lack of adequate and timely treatment can lead to loss of binocular vision, persistence of double vision, unsightly appearance of the eyes.

The treatment can be one of the following or a combination of these:

  • Optical;
  • Orthopic;
  • Treatment of amblyopia;
  • Surgical treatment;

Conclusions of the study by Dr. Daniel Mojon, strabismus ophthalmologist at Kantonsspital St Gallen (Switzerland)

“It’s never too early to correct strabismus. The operation to correct strabismus in children up to 6 years of age prevents the phenomenon of their social isolation”.

To support his thesis, Dr. Daniel Mojon published in The British Journal of Ophthalmology a study conducted on a sample of 118 children to determine the relationship between strabismus and discrimination. If before the age of 6 children do not stigmatize their colleagues who suffer from this visual defect, the situation is different after this stage.

Dr. Daniel Mojon and his team modified the photos of 6 pairs of twins, creating an artificial strabismus in one of the two children. The images were then presented successively in front of a group of 118 children, aged between 4 and 10 years. They were asked to designate which twins they would or would not invite on their birthday. One of the 31 children aged 4-6 years (3.2%) did not select any children with strabismus. Among children aged 6-8, the discrimination rate rises to 37.5%, respectively 18 out of 48 children did not select any affected children. Between the ages of 8 and 10, most children (56.5%) did not invite any of the children with strabismus.

Therefore, discrimination related to childhood strabismus increases with the age of children. Also, said Dr. Daniel Mojon, a corrective surgery should be performed before age 6, an age that seems to mark the onset of the negative social implications of strabismus. In support of their argument, the researchers cite other studies that show that some educators also had a negative attitude towards children with strabismus.

1. Project overview

Through the medical project “Correcting strabismus” we come to the aid of children and adolescents in social day care centers, family-type social apartments or socially disadvantaged families, who have this condition.

In most European countries, strabismus is no longer a major problem, children with this eye condition are being correctly diagnosed at an early age and treated properly, which contributes to a considerable increase in the chances of correction. In Romania, among children and adolescents from socially vulnerable environments, strabismus still raises serious problems, in addition to the medical component there are social, emotional and educational implications. This reality motivated us to initiate the “Correction of strabismus” program in 2010

2. Step by step project description:

  • Initial visit to the ophthalmologist to determine the correct diagnosis and the type of treatment required depending on the type of strabismus.
    • The specialist doctor will make the necessary recommendations: applying the occlusion, wearing corrective glasses and / or surgery.
    • If necessary, a second medical visit will take place.

The children from Bucharest and the neighboring counties are consulted at the Oftalmix Clinic, Bucharest, by the team led by Dr. Luminița Teodorescu. https://oftalmix.ro/

The children from Cluj County and the neighboring counties are consulted at the Pro Visual Clinic, Cluj-Napoca, by the team led by Dr. Gabriela Bîrlea. https://provisual.ro/

  • If surgery is required, it will be performed at Medlife Pediatric Hospital, Bucharest.
    • When it is necessary to hospitalize the patient, accompanied by a parent or guardian, it will be 24 hours, during which time the child will be under observation.
    • The post-operative patient will benefit from check-ups at regular intervals: 2 months / 6 months / 1 year.
  • Logistics:
    • The association’s volunteers accompany the child and his / her parent / guardian to all medical visits.
    • The program coordinator will communicate with the parent / guardian or Department of Child Protection and Social Services representatives to prepare the necessary legal documents.
    • The association’s volunteers will provide the child with the necessary emotional support in case of surgery.

3. The benefits of the children’s program:

From a medical point of view: this eye condition is corrected, especially when patients are young.

From a social point of view: it increases self-esteem, helping the child to establish harmonious social relationships with other colleagues. It solves many of the inferiority complexes that appeared due to strabismus, contributing to a better integration in the society.

From an educational point of view: there was an improvement in learning outcomes, the child reading better and thus accumulating the necessary knowledge.

Within the program we monitor the results in a practical way that includes questionnaires, post-operative consultations, discussions with the medical staff and the caregivers of these children, pictures before and after treatment that provide conclusive images of the results.

4. Objectives:

Extending the program to all counties of the country, thus contributing to solving a medical problem with many negative implications in the lives of children from socially disadvantaged backgrounds.

 

Beneficiaries

Since the start of the project in 2010 and until now, 630 children from 26 counties of the country have received support. There were 1930 consultations and 288 surgeries.

Testimonials

What children and parents say about the project

Alexandru, 14 years old

We truly thank this association, without which we would not have allowed ourselves to operate on the child who came to our family at the age of 6 months, with a fairly pronounced strabismus. This team together with Dr. Irina Velcea, a doctor with a lot of professionalism, with spectacular results, helps children whose families do not have possibilities. THOUSANDS AND THOUSANDS OF THANKS!

– Filica

Leonard, 14 years old

You occupy a special place in the soul of our family. You did something, which for years I was not able to do: the smile that appeared on the face of a 14-year-old boy! My son, Leonard, underwent surgery to correct strabismus with the help of your association. I came to Dr. Irina Velcea, with a shy little boy, inhibited, having an inferiority complex caused by his “defect” but now he is a confident teenager, casual and with a lot of friends. The credit goes only to you, to the whole team and I would like to thank you again. All of you who have contributed to our happiness have our esteem and respect forever. Respectfully, a mother

– Anișoara

Andreea, 17 years old

I want to thank you with all my heart for everything. If it weren’t for you, the whole team, and today I was ashamed to go out on the street, as in the past everyone was telling me I was looking crooked… May God give you all the best for the happy children you have helped
Thank you again for everything you have done for me !

– Andreea