Strabismus, binocular vision, and adaptations

Strabismus, binocular vision, and adaptations
Strabismus, binocular vision, and adaptations

Strabismus or squint is one of the underlying pathologies that are, if presented in early childhood, likely to result in amblyopia. It is characterized by the deviation of the two eyes, which is problematic not only cosmetically, but it also profoundly affects healthy vision.

Our brain compensates for eye misalignment such as strabismus

Humans have our two eyes positioned in front of our skulls, which enables us to have a very good binocular vision and the perception of depth. This allows us to drive, play sports, or walk without too much effort. When our two eyes are properly aligned, our retinas will simultaneously send balanced signals from each eye and the brain will be able to calculate and judge the distance of objects in space effortlessly with great precision. If, for whatever reason, our two eyes become misaligned the latter will become impossible. Our brain is then left with two options, neither of which are good.

The first one is diplopia or double vision, which would result in doubling everything we see – pretty annoying right? The second one, though, is simply shutting down the signals coming from the deviating eye – resulting in the loss of binocularity and the perception of depth. In young children, due to high brain plasticity, the latter is usually what happens. Short-term, this is a better option of the two, as the kids thus very rarely experience bothersome double vision, but long-term, it can lead to deep amblyopia with impaired visual acuity of the deviating eye as well as decreased ability to develop a healthy binocular vision and the perception of depth.

Restoring binocular function is just as important as restoring visual acuity

The goal of strabismus and amblyopia treatment is then to restore the visual acuity of the deviating eye as well as to establish healthy binocular vision without the impaired perception of depth. It is usually achieved so with a combination of correct refractive correction, patching, sometimes surgery, and vision training such as Amblyoplay.

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