The role of glasses in the treatment of strabismus has been known for over a hundred years. Part of the strabismus conditions are essentially influenced by the presence of glasses as is the case of accommodative convergent strabismus. In this type of strabismus, the patient has his eyes perfectly aligned with the glasses on his eyes and strabismus occurs only in their absence. In case of this type of strabismus NO surgery is performed.
OFTAPRO can honour a prescription of glasses in a record time of 5 minutes, 6 days a week.
Usually these patients have large dioptres, with a (+) sign meaning high hyperopia. However, few people know that in these patients, contact lenses are a much better, more effective and more cosmetic solution than glasses.
Oftapro has been prescribing contact lenses for 25 years. New generations of contact lenses have evolved immensely and are becoming more comfortable and safer. Even children can wear contact lenses, it is a well-known thing. Sometimes they learn faster than adults to apply contact lenses. With close supervision, the benefits of contact lenses in accommodative strabismus are multiple: functional (vision is better, the field of vision is more extended, better binocular vision quality), cosmetics (strabismus will not be noticed by others) and increased freedom of movement can do sports without fearing that they will damage their glasses.
An excellent indication for contact lenses is represented by the very high dioptres but also by the big dioptre differences between the two eyes which are much better dealt with when using contact lenses.
Glasses. Lens types.
Glasses are indispensable in the treatment of strabismus where there are also refractive errors (dioptres) and can be prescribed from a very young age, 4-6 months. Their purpose is to give a clear image of the child’s retina but also to relax the eye muscles. They are not an “attempt” to correct strabismus but a mandatory step in its treatment.
A particular situation is represented by the convergent strabismus in which in order to keep the eyes in a parallel position both at close and far range while wearing the glasses, patients need glasses with special lenses called multifocal (progressive). Multifocal lenses have been used successfully in Oftapro for over 20 years in the treatment of convergence excess accommodative esotropia (convergent strabismus with greater deviation at close range and which align in the presence of a stronger lens at close range). Over time, these lenses lead to relaxation of the accommodative excess and correction of strabismus. Oftapro is one of the few clinics in the world specializing in strabismus in which the published results have demonstrated exactly the indications and the long-term effectiveness of multifocal lenses. They are mounted on glasses differently from the case of adults and therefore require the help of a specialized optician as in Oftapro.
At Oftapro, children can be examined from the first days of life!
However, there are also cases of strabismus in which patients do not have dioptres and yet glasses can play an important role.
In large strabismus, without dioptres, the glasses have no role, the surgical indication is clear.
However, in small, intermittent, recently decompensated or newly installed paralytic strabismus, patients can benefit from the help of prismatic lenses, either included in the lenses of glasses or applied to the lens in the form of a foil – Fresnel foil. Their role is to restore binocular vision (the patient no longer sees double) and may be an intermediate solution until surgical treatment or until the strabismus corrects itself (recent paralysis or acute outbreaks in myasthenia gravis or other autoimmune diseases that are reversible) or definitive where there are contraindications for surgery.
Prisms are NOT prescribed in any kind of strabismus, they have very punctual and clear indications.