By John D. Ferris, FRCOphth
    Squint Clinic
    Pediatric Ophth/Strabismus, Strabismus

    Glasses are not usually required in this type of strabismus but an Optometrist or Ophthalmologist will carry out a refraction test to accurately assess the situation. In some cases glasses may help reduce the divergence. Occasionally a weak pair of short sighted glasses may be prescribed, as a temporary measure, to help control the strabismus.

    The vision of each eye will not normally be adversely affected by IDEX but if one eye diverges frequently the visual development may be delayed causing amblyopia (see amblyopia section). Patching can also be used to help improve the control of the divergent strabismus, but its use is not widespread.

    In an older child or adult, orthoptic exercises can sometimes help to improve the control of the strabismus.

    Many children with IDEX will never require surgery as they are able to control their strabismus and it does not interfere with the development of their binocular vision.

    Reasons to consider surgery include:

    • If the child’s binocular vision begins to deteriorate
    • If the child is struggling to control their strabismus, even for close work
    • If the parents are aware of the strabismus for more than 50% of the child’s waking hours

    The principle aims of surgery are to enable the child to control their strabismus and to restore / improve their stereopsis (3D vision).

    Republished, with permission, from www.squintclinic.com