Complications
Strabismus in children may cause suppression (active process of the central nervous system by which the visual input of one eye is ignored) of the image created by the non-fixating eye resulting in amblyopia (decreased vision in an anatomically normal eye caused by suppression) and irreversible loss of vision if not adequately treated.
Although amblyopia generally develops in children ages <7 years, there is no universally accepted upper age limit, and it can occur at any age prior to the development of visual maturity. This complication does not affect patients with adult-onset strabismus.
The risk of amblyopia is higher in younger children, constant strabismus, and esotropia (compared with exotropia).[50]
The likelihood of the development of decreased binocular vision functions (e.g., depth perception and stereopsis) is high in manifest strabismus, medium in intermittent strabismus, and low in latent strabismus.
Risk factors for the development of decreased binocular vision include the onset of strabismus at a young age, prolonged duration of strabismus, and constant deviation.
Strabismus may have a psychological and social impact on the patient. As misalignment of the eyes is abnormal, it is considered to be a deformity rather than a cosmetic problem.
Several studies have investigated the psychosocial aspects of strabismus, and it has been shown that individuals with strabismus have higher levels of social anxiety and social avoidance, and that surgical alignment of the eyes results in significant improvements in these areas.[51]
Visible strabismus may also negatively influence the ability of a person to find a job or a partner; exotropia has been found to be a more significant factor in the latter than esotropia.[52][53] Surgical realignment of the eyes can eliminate these negative impacts and improve quality of life.
People with strabismus have been found to be more likely to develop mental illness by early adulthood than those without strabismus.[54] There seems to be no correlation between childhood esotropia and mental illness, although there is a strong correlation between childhood exotropia and mental illness. The reasons for these findings are unclear.
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