Is vision therapy effective for treating strabismus in my child?

Doctor's Answers 1

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Dr E-Shawn Goh

Ophthalmologist

Thanks for your question! I think your instincts are correct! The evidence still supports patching as directed by your attending Ophthalmologist, and perhaps convergence exercises (aka Pencil push-ups, if there is an element of convergence insufficiency in the intermittent exotropia).

Your Ophthalmologist would have evaluated your child to exclude a secondary cause for the exotropia, and would be working with you to optimise her final visual acuity and alignment in order to maintain excellent visual acuity and binocular vision.

At some stage as she gets older, your Ophthalmologist may suggest the option of strabismus surgery to assist your child in consistent alignment of her eyes in order to maintain binocular stereopsis throughout the day.

Vision therapy as you described it, is best reserved for once you are successfully patching your childs' eye as instructed by your ophthalmologist (and performing alignment exercises as directed), and if you have a surplus of time and energy with excess financial resources.

ESG

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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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