Getting aligned about being cross-eyed

The medical term for libat is nothing to be cross eyed about. Strabismus or more commonly known as cross-eyed or wall-eyed is a condition in the eye where a person cannot align both eyes simultaneously under normal conditions. One or both of the eyes may turn in, out, up or down. Children with strabismus may initially have double vision because of misalignment of the two eyes.

In an attempt to avoid double vision, the brain will disregard the image of one eye. Over time, this disregarded or suppressed eye will eventually not function because it somehow loses the stimulus to see. The brain stimulus of people who are libat is such that only one eye is functioning so that there is a focused vision while the other eye that is not functioning or no longer has stimulus becomes an “incapacitated” eye or “lazy eye.”

Dr. Loren Yap Ong, the first Pediatric Opthalmologist in Cebu and in the region, deplored that sometimes the lack of awareness impedes strabismus patients from early detection, treatment and rehabilitation. Dr. Ong said that while there is no census in Cebu about children or adults affected with strabismus, but then most parents don’t care much about checking anatomical alignment of their children’s eyes and those who do see that their child is cross-eyed don’t go to a doctor because they don’t know there is treatment.

Strabismus cannot be outgrown.

No one knows exactly when children or people get cross-eyed. Some say it is in the genes or hereditary. But all this time we have been cross-eyed about being cross-eyed. Apparently it is easy for us to talk about promiscuity and sexually-transmitted diseases in a campaign to create awareness about AIDS or the Acquired Immune Deficiency Syndrome. But we are apprehensive to offend a person who is cross eyed and just tell him that by seeing a doctor something can be done to align his eyes. Dr. Ong said there is a great need to create awareness about strabismus if only to encourage parents to have their children checked from 0 to 3 or 6 months just to see if the eyes of the baby are anatomically aligned.

Dr. Ong said most parents tend to think that the cross-eyed condition of their children can be outgrown. Thing is, it can’t. Children who are cross-eyed will remain cross-eyed for life if they are not treated. Not only will they not be able to see clearly, but the suppressed eye will no longer function and that’s a sad thing.

Treating children with strabismus has two options and that is, treatment with refractive lenses or eyeglasses and through surgery. Dr. Ong said that when the strabismus condition of the child can be treated with eyeglasses he would rather make the child use glasses. He said that over time the glasses correct the alignment of the eye while the child’s brain is still developing.

Cutting the eye muscle.

It is because the eyes are made up of muscles that strabismus can be treated or aligned with surgery. The doctor makes an incision underneath the eyelids, cuts a muscle, adjusts and sutures this to alignment. It takes just a few minutes to do it but as Dr. Ong said, “the challenge is not in the surgery but after where rehabilitation is needed.” The aligned or adjusted eyes are actually rehabilitated so that it is trained to have the proper focus.

Strabismus surgery though has two purposes: one is for functionality which restoring the eye to an aligned focus and aesthetics like cosmetic surgery so that the eyes are anatomically aligned. Among cross-eyed adults the most that surgery can do is for aesthetics. In most cases the eye can no longer be restored to aligned focus because the brain never got the chance to be stimulated to see. The muscles of our eyes need to be stimulated to transmit images and signals to the brain and cause the brain to see what we are supposed to be seeing.

We need to stimulate the muscles in our perception to see strabismus in an aligned focus. It is in awareness that strabismus patients will have hope about treatment. We don’t need eyeglasses or surgery for that. We just need an open mind and an open eye to get the treatment of strabismus to focus.