I was born with an ophthalmological malady known as strabismus — ocular misalignment; a condition in which the eyes are not properly aligned and commonly referred to as crossing of the eyes. Mine was a combination of inward— esotropia and outward —exotropia versions. It typically involves a lack of coordination between the extraocular muscles which prevents bringing the gaze [a long steady look or stare] of each eye to the same point in space, thus preventing proper binocular vision — stereopsis or stereoscopy; which may also adversely affect depth perception.
Esotropia is the most common type of strabismus in infants. Accommodative esotropia develops in children under age two who cross their eyes when focusing on objects nearby. This usually occurs in children who are moderately to highly farsighted (hyperopic). I’m farsighted. Another common form of strabismus, exotropia, may only be noticeable when a child looks at far-away objects, daydreams, or is tired or sick. Sometimes the eye turn is always in the same eye; however sometimes the turn alternates from one eye to the other’. Most children with strabismus have comitant strabismus. No matter where they look, the degree of deviation does not change. In incomitant strabismus, the amount of misalignment depends upon which direction the eyes are pointed.
Strabismus can be either a disorder of the brain in coordinating the eyes, or of one or more of the relevant muscles’ power or direction of motion. Mine was related to eye muscle function. One eye appears to move normally, while the other eye points in, out, up or down. Strabismus is often referred to as “lazy eye” and is also referred to as “squint”, “crossed eye”, “spaggy eye”, “google eye”, “boss eye”, “cock eye”, “cod eye”, “sockeye” and “wall eye.”
Difficult strabismus problems are usually co-managed between orthoptists (corrective lenses, eye patching and if necessary, surgery) and ophthalmologists that perform the delicate eye surgeries necessary in most cases to set the eyes toward a normal, binocular pattern.
In more technical, ophthalmologic terms, “Cross-eyed” means that when a person with strabismus looks at an object, one eye fixates on the object and the other fixates with a convergence angle less than zero, which is the optic axis overconverge [inside]. “Wall-eyed” means that when a person with strabismus looks at an object, one eye fixates the object and the other fixates with a convergence angle greater than zero; which is the optic axis diverge from parallel [outside]. In lay terms, this means one turns inward and the other outward; thus the names “cross-eyed” and “wall-eyed.”
During eye examinations, ophthalmologists and optometrists typically use a cover test to aid in the diagnosis of strabismus. If the eye being tested is the strabismic eye, then it will fixate on the object after the straight eye is covered, as long as the vision in this eye is good enough. If the straight eye is being tested, there will be no change in fixation, as it is already fixated. Depending on the direction that the strabismic eye deviates, the direction of deviation may be assessed.
A simple screening test for strabismus is the Hirschberg test. A flashlight is shone in the patient’s eyes. When the patient is looking directly at the light, a reflection can be seen on the front surface of the pupil. If the eyes are properly aligned with one another, then the reflection will be in the same spot of each eye. Therefore, if the reflection is not in the same place in each eye, then the eyes aren’t properly aligned.
When strabismus is congenital (my mother had “lazy-eye” which became noticeable with fatigue) or develops in infancy (as mine did) it can cause amblyopia in which the brain ignores input from the deviated eye. When I try to focus with my weaker eye—the right; esotropic eye, my vision begins to blur and falters rather quickly from focus that is very keen with my dominant — normal; left eye.
The appearance of strabismus may also become a cosmetic problem with many. One study reported that 85% of adult strabismus patients reported that they had problems with work, school and sports because of their strabismus. The same study also reported that 70% said strabismus had a negative effect on their self-image. As a young child I had to wear patches and corrective lenses in an attempt to align the developing muscles in my eyes. I cried as a three, four and five year old child from having to wear those patches and corrective glasses. The constant tearing off of the eye patches left my tender young face red and the skin around my eyes quite sensitive.
I could feel the tug on my eye muscles from the corrective lenses and it caused me quite discomforting — physical pain, soreness and headaches. At such a young age my senses were razor sharp and the discomfort became amplified in effect. Emotionally, I didn’t like what the other kids said about me. It hurt my very young feelings. But I was continually reassured by loving parents that it would make me see better. So, as an obedient child I followed their will for my improvement and hesitantly embraced the process until I was eight years old. It was then, that I had surgery to correct the problem.
I would usually squint my right eye shut in order to prevent the frequency of the inherent double-vision condition from occurring. My childhood ophthalmologist was amazed that I was able to keep the vision in my right eye from this physical and visual imperfection. I always felt that I was falling behind and wasn’t able to compete in the classroom — unable to connect; as well as I did with my athletic pursuits. With our brain being 50% visual and my eyes not being binocular, I was missing out on probably half the affective input to my brain for encoding the world and comprehending at a quicker—normal pace. So, I obsessed with my athletics__overcompensating; and just did my best in school to pass my classes.
When I entered the University of Washington as a freshman chasing my childhood dream, my SAT scores were only fifty points higher than the minimum requirements. It had nothing to do with my intelligence. I just couldn’t comprehend what I’d read in the same way as other students, or as fast; because of my poor reading ability from the visual limitations I was dealt. I would have to try harder, which took longer — creating fatigue; so I’d opt out to do those things that gave me tangible gratification, and more noticeably quicker accomplishment. These physical aversions became my strength. Some would say that I was lazy and didn’t want to work at school hard enough like my high school French teacher had commented on occasion. “Kevin, If you’d just put as much energy into your studies as you do with your sports – you’d be a straight “A” student!”
As a result of this infancy related issue; as I grew up, I became a slow — word-by-word — reader as I am today. I would tire quickly; which would usually send me off in a daze, daydreaming or doing other things or even falling asleep. It still does, as I frequently nod off until something awakens me and reminds me that I have reading to do.
Because my focus moved away from athletics, to making a living and helping raise three kids; I tried much harder than when I was young growing up when athletics came so easy for me or anything else that involved manual dexterity. There would be many occasions in school when I’d just stare out the window and daydream about my future.
I was a dreamer at heart — one possessing a grand and active imagination. My creative instincts would then forever take me on wonderful journeys; traveling through a multitude of enchanting dreamscapes as I’d sore to lofty heights, with their flights of fantasy to a future with great accomplishments and many successful victories in my life.
A New Revelation
In Susan Barry’s book — Fixing My Gaze — www.fixingmygaze.com: Susan’s highly, scientifically detailed accounting in coping with Strabismus is most revealing. Susan’s condition is almost identical with what I’ve lived with during my life was most revealing and specifically because we’re the same age. Finding Susan’s book has now opened up a great understanding of what I’ve lived with my entire life in terms of My True Vision.
Susan has an accompanying website: www.stereosue.com which gives an even greater accounting and detailing other scientific data for those coping with Strabismus and another aspect of this eyesight glitch known as Convergence Insufficiency [CI]. It was discovered that there are five overlapping diagnostic criteria associated with CI and ADD/ADHD. There is a tab below where I’ll discuss these overlapping conditions.
Because of this most recent revelation concerning My True Vision—I’m following up with Susan to discuss what my possibilities are of obtaining stereopsis—stereoscopy—binocular vision so images appear for me in 3D as they now do for Susan. I am also pursuing the Lasik alternatives to bring my original farsighted vision back to normal 20/20 dioptic acuity.
I hope this information has proved helpful in understanding—as brief as my relative comments have been—in coping with your own strabismus or a loved one’s needs with their vision issues. You will also find in another tab; an eye condition known as — Optic Nerve Hypoplasia. One of my grandsons is afflicted with this optic malady and it’s one of my goals to bring awareness to this adverse; randomly occurring condition.