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Strabismus Surgery
I'm an adult with strabismus, and lately I've seen quite a few blogs on YouTube of pre/post op strabismus procedure. I have 80% depth perception, and to be honest it's more of a psychological ailment than a physical one. Is this something that you would recommend for me? The few contacts I spoke to said it's quick, easy, generally quick recovery and they would do it every single year if they had too.
Any information you could give me about this procedure, such as contacts, price, pro/cons, risks, ect would be greatly appreciated.
Dr Henry Smit's response:
Dear Dave:
If you have 80% depth perception, it would seem to me that your eyes are likely aligned part of the time, or had been aligned at some time in the past. The chance of success with strabismus surgery tends to improve if the eyes have a pre-existing ability to co-ordinate and work together – which it appears that yours have.
Your first step should be to consult an optometrist to have a binocular vision assessment. He or she will be able to measure the degree of strabismus as well as your binocular depth perception. Based on the results of your assessment, your optometrist can refer you to an eye surgeon who will be able to discuss the potential benefits and risks of doing the surgery in your particular case. The benefits and risks vary from case to case based on the degree of misalignment and the direction of misalignment. However, based on your 80% depth perception, it appears that the possibility of corrective surgery is an option worth investigating in your case.
Best of luck,
Dr. Smit
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Development of Myopia
Bernie wrote:
I'm a 47 year old male. I started wearing glasses for very mild myopia and astigmatism at age 18. I was told at the time that by age 23 my prescription would probably stabilize, but that has not happened. I just found out last week that my myopia and astigmatism have changed yet again (my myopia is now at -4).
My question is: is there a chance that this will go on into old age? What am I doing wrong? I read a lot (under good lighting) and I spend a lot of time in front of a computer (two to three feet away), but that is my job unfortunately. Besides, I have countless colleagues who do the same and do not even wear glasses.
Which brings me to my second question: given that no one in my family wears glasses, is it possible that I caused my own myopia/astigmatism by studying and reading too much when I was in my teens? I've heard of studies that claim there's no correlation between reading/studying and myopia, but I find that hard to believe.
Your answers are much appreciated.
Dr Henry Smit's response:
Dear Bernie:
The debate about whether or not doing close work contributes to the development of nearsightedness has been argued for years without reaching a definite conclusion. It is believed that a number of factors contribute to the development of myopia, with genetic predisposition being near the top of the list. Although no one in your family wears glasses, I would not be surprised if you had more distant blood relatives who also had some measure of myopia.
It is true that, in typical cases, myopia stops progressing once the person’s eyes have reached their full adult size – usually in their early twenties. That being said, I have certainly seen patients in my practice who, like you, have continued to become more nearsighted through their adult years. A good number of them, like you, had spent a lot of time doing near tasks, but for many that was not the case. Additionally, there are many people today who spend much of their work time doing close work, and then spend several hours of leisure time doing close work such as reading or working on a computer. For most of these people, myopia does not progress.
Bernie, I don’t think the amount of near work you did was the cause of your nearsightedness. It could be argued that your near work may have contributed in some difficult to measure fashion, however, I do not think you need to blame yourself for your nearsightedness. The mechanisms that cause myopia are complex and not yet fully understood and not usually entirely attributable to the amount of close work that has been done.
Hope this is helpful.
Dr. Smit
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Migraine-Related Eye Problems
Brenda wrote:
Hi, have a question.. I've been having a reoccurring problem with my eyes, been on and off for about 2+ years now. I've been to the dr, he seen nothing physically wrong, said I could see an optometrist if I wished. Just called them, they are just going to do the normal exam, not sure if they can figure out what's wrong with just the exam?! My symptoms start like this.. Sudden blur, almost as if someone throws a bottle of black ink in my eyes, then just all over blur like I'm looking through a kaleidoscope almost. Then it is almost like my eyes fill up with water, like from the bottom up, it's just the sensation I feel warmth and then the vision slowly blurs from bottom of eyes up. These are sudden and random things.. My eyes continue to be completely blurry and I can hardly see for at least 20-40 minutes each time this happens? Please help, because the drs have no idea!! Thank you :(
Dr Langis Michaud's response:
Dear Brenda
You describe the visual aura linked with the classic migraine syndrome very accurately. This is just like in the textbooks. Having this problem myself I certainly understand how confusing this occurrence could be. First of all, I have to say that this is a very benign, but spectacular, phenomenon that happens usually under certain circumstances. Stress and fatigue are the main triggering factors associated with visual aura. This could happen also around menstrual cycle on women, some being affected before their menopause, some being impacted only after their menopause. Smoking is also a factor to consider, because the phenomenon is related to a short-term constriction of small blood vessels at the base of the neck, at the back of the head. Our visual cortex (where our brain interprets what eyes are seeing) is located just above this area. When vessels are restricted, there is a temporary lack of regular blood supply in the area. It triggers a kind of short-circuits neurologically speaking and the kaleidoscope images appear. It last for 10-15 up to 45 minutes. After that, there is an automatic release of chemical mediators, naturally produced by our system, that allows the vessels to dilate in order to restore the blood flow in the visual cortex. Images are fading away but vessel dilation is at that time related to the occurrence of a malaise and/or a migraine that can last for 24 up to 48 hours. Some patients are not feeling any headache at all — this is possible but most of the time there is certainly some nausea or malaise that follows such episode.
One thing to investigate, when this occurs on a frequent basis, is some misalignment of superior vertebrae of the spin. Some patients who are doing computer work for many hours every day, or patients who had sports minor injury around the neck can have a misalignment of the vertebrae. Blood vessels traveling there can be easily compressed leading to the visual aura phenomenon. In this case, headaches are rare.
Consequently, I would consult a physiotherapist or a chiropractor to make sure that everything is ok around the neck area and if this is the case, when the episodes are coming, take 1-2 Tylenol tabs to reduce the symptoms and the intensity of the following headaches. Alleviate stress and fatigue is easy to say but never easy task to do… but this can help. If you are smoking, please cease to smoke… this affects blood vessels and supply and could favour such occurrences.
Again, this is very spectacular but very benign. Your vision will never be permanently affected by this neither your neurological functions. Nothing wrong can happen from this anomaly. However, as I say to my patients, this is a warning sign of your nervous system telling you that it is time to relax a bit…
Be Zen!
Dr Langis Michaud, OD, MSc, FAAO (Dipl)
Associate Professor – U de M
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