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Surgery or Therapy?

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Let’s first make sense of this by discussing strabismus. Strabismus (an eye turn) affects more than the way we look. It also affects the way we see. When eyes are straight, each eye sends its own picture to the brain. The brain combines these two pictures into a three-dimensional image, thus creating “depth perception” or 3-D vision.

When an eye first crosses, the pictures from the two eyes no longer match and the brain cannot make sense of this doubling. At this point, the person with the turned eye may run into things, knock over drinking glasses, etc. If the eye is allowed to continue crossing, the child usually learns to ignore or “suppress” the information from the deviated eye. As a result, the child no longer suffers from double vision. At the same time, however, depth perception is lost. And, if the same eye is always turned in, the eye can become so ignored that the sight from that eye is lost. This partial sight loss is called “amblyopia”.

In studying this, we know that strabismus is a brain problem, not an eye muscle problem. The brain fails to coordinate the muscles to align the eyes. Our goal in vision therapy is two eyes that not only appear straight (surgical goal) but work together for the best depth perception and performance in school, work, driving, or sports.

Vision therapy works by providing biofeedback to teach the brain to blend the information from the two eyes (fusion). Eye alignment is then rewarded with 3D vision. Frequently this process can align eyes without surgery. In other cases, vision therapy is performed after surgery to help keep the eyes aligned and to improve depth perception for school, sports, and driving. In vision therapy, we are teaching the brain to control and make sense out of the vision that the straightened eyes are sending to the brain. Please consult your local developmental optometrist to help make the best decision for your child.