Strabismus

Hi, I have strabismus. It seems to be getting worse or maybe i'm just
imagining it. I was wondering if there are any ways that can prevent
it from getting worse or reverse the process without surgery. I've
been told that once its been with me through adulthood, its hard to
correct it whether its exercise or surgery.

 

It really depends on the type, the degree, whether there is any
amblyopia present, and whether there has been nerve damage.

Insofar as therapy is concerned, exo-deviations are easier to train
than eso-deviations, unless the eso-deviation is caused by uncorrected
hyperopia, in which case glasses can help.

DrG

 

There are different schools of thought on reversing strabismus:

1. You are stuffed

2. You might possibly be helped in rare examples.

3. Providing you are prepared to consistantly adhere to a program of
techniques you can recover at any age.

Generally this newsgroup is populated with the 1. School of thought.

3. Can be provided thru a behavioural optometrist.

Andrew

 

Andrew Judd is an egotist who seeks attention. Do not pay any regard to
his postings. He has no background in Visual Science, Optometry, or
Ophthalmology.

 

What do you mean by this? If you search previous threads, you will find
that the answer most often given is option #2.

Option #3 is actually the same as option #2. Strabismus can be treated
through exercises and therapy in only a limited number of cases, very much
dependent upon the details of the particular case. Strabismus associated
with eccentric fixation, anomolus correspondence, suppression, amblyopia,
noncomitant deviation and monocular deviation is unlikely to be successfully
treated with therapy. Strabismus that is alternating, non amblyopic,
varible suppression, and variable correspondance is more likely to be
treatable with a good outcome, the later type of strabismus is rarer than
the former.

Dr L summed it up nicely:

"It really depends on the type, the degree, whether there is any
amblyopia present, and whether there has been nerve damage."

The original poster needs to return to his eye care provider to find out if,
in fact, his strabismus is getting worse and whether, in his particular
case, therapy would be of any value.

For most adult strabs, the main issue is cosmesis --- they don't like the
appearance of the wandering eye and surgery is easier, more predictable and
more likely to have a good cosmetic outcome than therapy.

Dr Judy

 

I think we all know what he meant by this. This guy is a jerk seeking
gratification by posting his "opinions" in this newsgroup.

 

"stuffed"

Adj. 1. Concerned, bothered. Usually phrased in the negative. E.g."I'm
not stuffed with going out drinking tonight."
2. In a position of no hope.

http://www.peevish.co.uk/slang/s.htm

 

"stuffed"

Thanks.
Perhaps I spoke too soon.
I owe Andrew the benefit of the doubt. Sorry Andrew.

 

My use of slang was not so helpful. Thanks Neil for explaining.

The problem in treatment of Strabisbus is the belief system of both the
person with strabismus and the person treating it.

Recently we have had endless arguments on eye movement.

It is clear can be to me that our eyes can independantly move relative
to each other in order to fixate on a target. Many people here
believe that is impossible.

There seems an obsession with conjugate saccades. If you believe in
all movement being conjugate then enivitably strabismus is going to be
difficult to cure.

But if you believe that all eye movement is attention driven and can
see that each eye can move independantly to fixate in any 2D plain
within a 3D scene to produce one binocular mergable image then more
possibilities exist.

There is a notion here that merging is driven by image differences as a
reflex that cannot be altered by conscious control. But it is easy to
demonstrate that the finer parts of our movement are under conscious
control

Brain science does not have all the answers yet but many here seem to
have a view of eyes that is driven by outdated text book ideas that
dont match normal eye function as demonstrated by normal people with
good vision.

By some method independant eye movement is possible depending on what
it being attended to ***or*** not. Since there is a degree of
independant function. Independant or depressed or dominating attention
is possible.

Evidence shows that via amblyopia there are possibilities for long term
hemispheric bias in visual attention. Altering that is never going to
be easy but impossible is not the correct word.

To say that 2. is the same as 3. is just a biased viewpoint from a
person who believes 2.

Andrew

 

major snip

Please cite clinical evidence about the success rate in non surgical
treatment of adult strabismus, especially evidence of success approaching
100% in treating all (not selected) cases. Then I will believe number 3.

Dr Judy

 

Please cite clinical evidence about the success rate in non surgical
treatment of adult strabismus, especially evidence of success
approaching
100% in treating all (not selected) cases. Then I will believe number
3.


Well in reality there are a great many different other schools of
thought between 2 and 3 with corresponding claims of success or not and
a great deal of greyness inbetween.

Similarly it appears that you yourself are positioned somewhere between
1 and 2 for many of your clients wanting help, rather than exceptional
cases which are truelly beyond treament.

Each case has to be different. I imagine your failures are only
failures because you dont know how to treat these patients and have
made assumptions about normal human eyes that are unreasonable as
demonstrated by your comments in previous threads over many years on
how eyes move.

 

So, now you agree with us that only some cases are treatable, not, as you
previously said:

"Providing you are prepared to consistantly adhere to a program of
techniques you can recover at any age."

Dr judy

 

Dr Judy said
you
previously said:
techniques you can recover at any age."

Some rarer cases are untreatable, but there is no reason why the
majority of cases cannot be treated providing a person can realise that
its not a simple matter to alter such a fundamental brain/eye
coordination problem such as Strabismus.

Doctors who believe that strabismus is just a muscle problem cannot
understand the complexities involved in strabismus. The problem is not
the muscles but the device that controls the muscles, which is
something they have no training in. Strabismus reflects a
significant brain 'problem' and one that behavioural optometrists
believe can be treated if a wholistic approach to the problem is
considered that is more than just eye exercises or surgery. These
optometrists have noticed that Strabismus often arises after periods of
difficulty for the inflicted person.

And no I am not going to satify your desire for studies to support this
view. If you want to find out more go and talk to a behavioural
optometrist who specialises in childhood strabismus.

Andrew

 

These

Because you can't

 

Excuse me, but I think most real doctors do indeed have training in "the
device" you mention, the brain. Do you? Do your friends who are
feeding you this stuff? How about some credentials? Have you or any of
your friends taken any brain courses at all? I doubt it.

These

Now that is one of the weirdest statements I've heard yet. Name me one,
just one study that even attempts to confirm that statement. It is NON
science!

Ok, no problem. I didn't expect you to...

w.stacy, o.d.

 

Where did you get the huge chip on your shoulder regarding science in
general, and optometrists in particular? You're just another Otis, but
not as logical.

DrG

 

DRG said

general, and optometrists in particular? You're just another Otis, but

not as logical.

I have a science degree. I believe in the scientific method.

I attempt to explain what I observe.

For example I observe that when stressed a friend of mine developes
strabismus so that her right eye points inwards. I observe that she
has never been treated for Strabismus and never been diagnosed with
Strabismus. This problem does not create issues for her and is an
infrequent occurance.

Nevertheless i am curious as to how this event is happening . What i
have discovered is that people do not yet have scientific answers to
this kind of observation.

 

Your friend has intermittent strabismus. The fact that it has not been
"officially" diagnosed is beside the point. Intermittent strabismus
only causes problems...intermittently.

Why is it happening? If she is or was a hyperope, that would be one
explanation.

I totally agree that satisfactory explanations do not exist for a
number of phenomena.

DrG

 

Well it is not just intermittant strabismus. It appears to be
intermittant strabismus caused by certain personal stress of a
particular kind. She is -5.5 myopic and astigmatic. 180 degrees
right eye.

Right eye deviations seem more common from my observations.

Also it seems more common for the right eye to be worse when there is a
difference. It would be nice to have more data than i have so far
collected.

In a model that recognises that the right eye tends to be the left
hemispheres eye these things can make at least some sense - even if so
far there are no satisfactory explanations for how this can be
possible.

Patching an eye appears to preferentially stimulate parts of the Brain
so that verbal responses are different for each eye. These responses
appear to indicate that the responses are related to contra lateral
hemispheric stimulation. Again there is no satisfactory explanation
but the observation is in the psychological literature and its
relatively easy to demonstrate this for oneself for at least some
patched people.

Andrew

 

Mike Tyner said

Perhaps you did not notice that I said "preferentially" rather than
"entirely or only".

Did you read this reference that appeared here recently?

http://brain.oupjournals.org/cgi/content/full/125/9/2023

Andrew