Can strabismus be corrected with eye patching?

Doctor's Answers 1

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Dr Daphne Han

Ophthalmologist

Strabismus or squint is a misalignment of the the eyes. The commonest type in our community is what you child has: intermittent exotropia (XT).

In general this is a more benign type of squint compared to its opposite which is esotropia.

In intermittent XT usually the eyes take turns deviating outwards, with the one that turns out more often risking becoming more "lazy". But on the contrary, patching is done on the eye that is LESS deviated i.e. the more "normal" eye so as to allow the "problem" eye to "work harder" and become less "lazy"

The patching does not usually change the angle of the squint much. It simply prevents the more deviated eye from slipping into irreversible "laziness". The scientific word for this laziness is amblyopia. It is very important that the patching is done properly before the child turns 8 year old, as that is when visual maturity is reached. If not done properly before this, there is a high risk that the lazy eye cannot be reversed anymore even with future patching.

In general when there is squint the depth perception/ 3D vision of the person will be affected. That may affect some fine vision function, like performing microsurgery for instance.

If the child and family are conscious of the squint, eye muscle surgery to straighten the eye can be considered.

Hope that answers your question, and best wishes!

Dr Han

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Answered By

Dr Tony Ho

Ophthalmologist

What is the effect of LASIK on strabismus (cross-eyed)?

Thanks very much for your enquiry. Generally speaking, I would advise LASIK before any squint/strabismus surgery. This is because there is a risk that changing the spectacle power of the eye (via LASIK) may make the intermittent exotropia more obvious if a patient finds it harder to ‘fuse ‘ the images from each eye after LASIK. If so, the strabismus surgery can then address the full effect and magnitude of the squint. Ideally, if strabismus surgery is required, it would be performed at least a month after LASIK surgery when the vision and spectacle power has usually stabilized.

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