The newborn's squint is not always the norm: how to determine and take action on time?
In a newly born baby, the visual analyzer is not fully functioning. It is characterized by hyperopia and photophobia. Because of the anatomical features, convergent strabismus in newborns occurs, which is not a pathology. If by 2 - 3 months it does not pass, the child should be shown to an optometrist. In this case, the baby can be diagnosed with strabismus.
Causes of strabismus
With strabismus (strabism) it is impossible to fix the gaze on a particular object. Pupils can look towards the temple - divergent, or deviate towards the nose - converging. This is not only a cosmetic defect, but also a serious disease in which there is a violation of stereo vision.
The causes of strabismus in children depend on the type. There are such forms as:
Strabismus, which occurs due to visual impairment, called friendly.
It occurs with such pathologies:
- Reduced visual acuity. When visual acuity is below 0.3 or the difference between both eyes exceeds 0.4, a squint occurs.
- Aniseycomy. In this disease, an image of various sizes is formed on the retina of both eyes. Therefore, the combination of the image in the cerebral cortex is impossible.
- Inconsistency of convergence and accommodation. Due to the abnormal development of the muscles of the oculomotor apparatus, eye strain occurs. As a result, people who are prone to farsightedness develop converging squint. In a child with myopia, there is a divergent squint.
- Congenital or acquired pathology of the muscles and nerves of the oculomotor system. Accordingly, the eyes can not look at one point at a time.
- Pathology of cortical and subcortical structures of the brain, in which the fusion and projection of the visual image.
- Reduction of the fusion reserve (the ability of the brain to merge images transmitted from both eyes).
- Impaired coordination of eye movement and gaze fixation.
In case of friendly strabism in a child, it is possible to prevent the progression of the problem by eliminating the primary cause. For example, with reduced vision, wearing glasses is recommended.
Paralytic strabismus occurs due to paralysis or paresis of the eye muscles. The reason may be:
- birth injuries
- congenital malformations of the central nervous system,
- diseases leading to CNS damage.
In a newborn child, the ability to focus vision only develops. In addition, the anatomical structure of the orbit is somewhat different. The vertical size is larger than the horizontal, the smaller the depth of the orbit - leads to the imaginary converging squint of the newborn.
When should a baby cross his eye
Normally, a newly born child is observed: uncoordinated, chaotic eye movements toward the nose, orbit of irregular shape. Looking at the baby, the impression of periodically occurring strabismus. Infantile strabismus in babies - pathology.
As soon as the child focuses his gaze on any object, the movements become coordinated. The visible effect of converging eyes disappears. Newborns from the first hours of life can cause a fixation of the gaze on a moving object, but it is still very unstable. When the child is 8 - 14 days fixation occurs for no more than 10 seconds.
By 2 - 3 months the baby can follow with his eyes the moving objects for a long time, until he loses interest in him. By this age, the effect of converging strabismus passes.
Constant strabismus in newborns, which does not disappear when trying to fix the eye, or does not pass by 3 months, is a pathology. Also, babies are not characterized by strabismus, in which one or both pupils look towards the temple, or are generally motionless. Such strabismus is caused by the paralysis of the eye muscles during birth injury or a violation of the central nervous system.
It is important to know! To prevent the development of strabismus, newborns should not be very close to the eyes to hang on the bed toys.
How to treat the problem correctly
Strabismus in children should be treated depending on the causes of it. Since strabism happens:
- Primary (independent disease of the visual analyzer). For treatment use special methods of treatment of violations of binocular vision.
- Secondary (the disease occurs due to organic eye damage). Very often occurs with cataracts, lesions of the retina and optic nerve. For treatment, the main cause of the disease should first be eliminated, and only after that strabismus is treated.
- Periodic strabism. The inability to focus occurs with nervous exhaustion, fatigue. For treatment it is enough to do exercises aimed at the development of binocular vision.
- Constant squint. It must be treated using special methods.
Treatment of paralytic strabismus
Before treatment, eliminate the cause that provoked the appearance of the disease. Without fail, before the correction of the vision, the child must undergo a re-examination:
- a neurologist (if the disease was caused by trauma),
- infectious disease specialist (after the transferred neuroinfection),
- oncologist (after removal of the tumor).
To eliminate strabismus, the same treatment methods are used as in the treatment of friendly strabismus.
If conservative treatment methods do not help, then surgery is prescribed. Special plastic surgery methods have now been developed, due to which partial restoration of eye movement is possible.
Common Strabismus Treatment
The treatment is carried out in stages:
- Eyeglass correction. According to the testimony, children can wear glasses from the age of 6 months. The sooner they are appointed, the better the result will be.
- Pleoptic treatment. Assign special exercises, wearing special glasses. Conduct it in order to restore the possibility of simultaneous fixation of the object with both eyes.
- Orthoptics. At this stage, carry out the restoration of normal binocular vision, using special exercises.
- Diploptica. Train the fusional reflex. At this stage, the possibility of simultaneous projection in the cerebral cortex of the object fixed by the eye is restored.
If this treatment does not help, the child is given surgery.
Treatment of strabismus in children will be more effective if it is started as early as possible. In order not to miss the onset of the disease, the child must undergo an annual thorough medical examination by an ophthalmologist.
What exercises to perform
When treating concomitant strabismus, very often special exercises are prescribed to eliminate the causes of the disease that provoked the appearance of the disease.
They should be aimed at:
- restoration of visual acuity
- removal of spasm of accommodation,
- recovery of convergence and accommodation,
- recovery fusion.
All exercises and workouts are prescribed by an oculist after a special examination.
Special exercises should correspond to the stage of treatment.
To begin with, they carry out the training of the biification reflex. It is the excitement of the patient in doubling in vivo. Exercises are performed using special prismatic glass and test objects.
Basic orthoptic exercises can be performed for children from 3–4 years after pleoptic treatment. Training is carried out on a special instrument - synoptic. Orthoptic exercises with the help of game interactive programs give a good effect.
Diplomatic exercises can begin to apply from 2 years of age. But the prerequisite is the symmetrical position of the eyes. This is achieved by therapeutic, surgical treatment or artificially created prismatic glasses.
Exercises for the treatment of strabismus are carried out in specialized children's institutions (kindergartens for visually impaired children, children's clinics, ophthalmological centers). Classes should be held only under the supervision of a specialist.
Peculiarities of infant vision
A newborn is born absolutely helpless - this also applies to his vision. The eyes of a newly born child have some peculiarities:
- the eyeball has a flattened shape, whereas in an adult it is completely round,
- Because of this eye shape, baby is born far-sighted,
- the first day the newborn responds only to the light source,
- until the second month of life, the fixation of the glance occurs only on large objects, the rest is seen by the child vaguely,
- after the third month, the newborn can distinguish all objects, but it can focus for a short time,
- lack of binocular vision - the baby sees the image not with two eyes at the same time, but each separately.
This explains the apparent squint in infants, which is sometimes noticeable immediately after birth.
Watch the video about the features of the newborn:
Causes and types
The most common type of strabismus (strabismus) in infants is physiological. It is explained by the features of the eyes of newborn babies. Underdevelopment and weakness of the muscles of the eyes leads to the fact that the newborn or mows his eyes to the nose, or they diverge to the temples. Most often, this form of strabismus occurs in premature babies.
The next frequent form of strabism is imaginary. It is associated with the features of the body:
- asymmetrical eye sockets,
- structural features of the facial skull,
- skin fold in the corner of the eye.
Rarely observed congenital form of the disease. The cause of congenital strabismus in children is heredity. If the parents have such a defect, there is a high probability that the baby will also develop strabismus. It is impossible to determine this in the first three months of life, since this period is accompanied by physiological strabism of the newborn.
Even less often such a visual impairment occurs against the background of any disease. The main causes of the pathological condition of newborns are:
- intrauterine viral infections - measles, rubella, CMVI,
- toxic damage to fetal brain areas responsible for the work of the eye muscles,
- birth injury,
- meningitis or encephalitis,
- parasites in the medulla,
- traumatic brain injury
- brain tumor.
Congenital and pathological strabismus is called true. There are two of its forms:
- convergent - a newborn mows his eyes to the inner corner,
- divergent - there is a divergence of the eyeballs to the temples.
Such strabismus is called friendly, as both eyeballs change their location. If the deviation is one-sided - they say about paralytic strabism.
How to determine strabismus
Parents can detect some signs that can suspect this pathology:
- the newborn looks at things for a long time, tilting his head to the right, then to the left,
- when looking closely at the lying objects, the kid squints,
- the newborn often rubs his eyes with his fists,
- can not immediately grab a toy or other object hanging in front of him.
Finding such symptoms in a very young child, parents begin to panic. It should be remembered that binocular vision and stable fixation of the gaze of both eyes are formed by four months of age. Only after this time can you identify signs of strabism.
If by six months all the listed symptoms persist, the newborn should be shown to an ophthalmologist. The doctor will tell you exactly how strabismus manifests in babies, and will conduct the necessary research.
Why children are born with squint, whether it is necessary to treat it and how to do it - determines the pediatric ophthalmologist. The physiological form passes on its own by 4–6 months, it does not require any treatment. For the treatment of other species using various methods. When the strabismus passes - an individual question. It depends on the characteristics of the body, the speed of development of the baby.
The well-known pediatrician Oleg Komarovsky does not consider strabismus in newborns to be a severe pathology. He points out that in the overwhelming number of children, strabism disappears by the age of four months. If the symptoms remain, timely examination by an ophthalmologist, proper treatment can get rid of the problem without any consequences.
In his opinion, how long a squint will last can not be predicted in advance. The average time for recovery of vision, all doctors indicate within 3-6 months.
Watch the pediatrician explanation video:
The main treatment for strabismus in newborns and infants is gymnastics. There are several exercise options that are selected according to the age of the child:
- a bright toy is driven in the face of a newborn, at a distance of 40 cm, from side to side, trying to watch it,
- bring the toy to the face of the newborn, then move it away,
- seat the child on a chair, turn on the lamp, close one eye and invite the child to look at the lamp for another for a few seconds.
Exercises do not less than two hours during the day, distributing them into several approaches.
The operation is carried out according to strict indications. When paralytic strabismus is found in a newborn, there is no effect from conservative therapy. The intervention is in the plastic of the eye muscles - shortening or lengthening them as needed.
After the operation, antibacterial and anti-inflammatory drops, healing agents are instilled in the newborn. The operation eliminates only a cosmetic defect, but does not restore vision. Therefore, the child must assign glasses.
In addition to the exercises, a child with a squint needs eye correction with glasses. They are prescribed to wear from 8-12 months. Points are prescribed based on the type of visual impairment - astigmatism, farsightedness or myopia.
Pleoptika - this method is used to correct amblyopia. So called lazy eye syndrome when strabismus develops on one side. A healthy organ of vision is closed with a tight bandage. The mowing eye has to work hard, due to which its correction takes place.
For a hereditary form of strabismus prophylaxis does not exist. Prevention of congenital strabismus in infants is:
- proper management of pregnancy for women
- healthy lifestyle,
- timely detection and treatment of viral infections,
- proper management of childbirth.
In order not to develop acquired strabism, parents should know the following rules:
- up to three months newborns see differently than adults
- up to four months physiological strabism is possible,
- the newborn should be given only large and bright toys,
- you need to develop your kid’s visual function daily,
- while maintaining signs of strabism more than six months, you should consult an ophthalmologist.
Squint of newborns is a frequent condition that occurs in most children after they have reached six months. In other cases, it is easily treatable, subject to timely diagnosis.
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