What are the causes of strabismus in children?

Generally, childhood strabismus may be caused by abnormal development of the extraocular muscles, refractive errors, conjunctivitis, congenital cataracts, brain lesions, or other factors. If discomfort occurs, timely medical consultation is recommended. Detailed explanations are as follows:

1. Abnormal Development of Extraocular Muscles

During embryonic development, congenital abnormalities in the position, length, or strength of the extraocular muscles may lead to uncoordinated eye movements, making it impossible for both eyes to focus on the same target simultaneously, thus causing strabismus. If the degree of strabismus is mild, symptoms can be improved under a doctor's guidance through wearing corrective glasses and undergoing binocular vision training, such as alternate occlusion training or synoptophore training. Regular vision and eye position examinations should be conducted to monitor changes in strabismus. If the condition worsens, surgical treatment should be considered following medical advice.

2. Refractive Errors

When children have refractive errors such as high hyperopia, myopia, or astigmatism, their eyes may over-accommodate to see objects clearly. Prolonged abnormal accommodation can affect the balance of the extraocular muscles, leading to strabismus. Prompt hospital visits for refraction tests are necessary, and appropriate corrective glasses should be worn under medical guidance to improve visual acuity. Daily attention should be paid to the child's eye posture, avoiding prolonged near work such as reading or watching television. Regular vision check-ups are essential to adjust the glasses' prescription according to visual changes.

3. Conjunctivitis

Conjunctivitis can cause itching, foreign body sensation, and other discomforts in children's eyes. Frequent eye rubbing may lead to uneven force on the extraocular muscles and may also affect the eye muscle's regulatory function due to inflammatory stimulation, causing temporary strabismus. For bacterial conjunctivitis, antibiotic eye drops such as tobramycin, levofloxacin, or chloramphenicol may be used under medical guidance. For viral conjunctivitis, antiviral eye drops such as acyclovir or ganciclovir may be used. Attention should also be paid to ocular hygiene, avoiding eye rubbing with hands, and maintaining ocular cleanliness.

4. Congenital Cataracts

Congenital cataracts can block the pupil, obstruct light entry into the eye, and prevent the retina from receiving clear visual stimulation. Prolonged blurred vision can easily lead to strabismus. Surgical treatment should be performed after medical evaluation to remove the cloudy lens. Corrective glasses or intraocular lens implantation may be required postoperatively based on individual circumstances. Regular postoperative vision examinations and visual function training should be conducted to promote the development of binocular visual function.

5. Brain Lesions

Brain lesions such as tumors or inflammation may affect the neural centers or pathways controlling eye movement, leading to extraocular muscle dysfunction and causing strabismus, which may be accompanied by symptoms such as headache, vomiting, or abnormal limb movement. If caused by brain inflammation, such as viral encephalitis, antiviral medications like acyclovir or ganciclovir injections may be administered under medical guidance. If cerebral edema is present, mannitol injections may be used to reduce intracranial pressure. Specific treatments should also target the underlying cause—for example, tumors may require surgery, radiotherapy, or chemotherapy depending on the case. Regular brain imaging examinations should be performed to monitor disease progression.

In daily life, it is important to help children develop good eye habits, avoiding excessive or insufficient lighting conditions during visual tasks. Adequate nutritional intake should be ensured, with an appropriate increase in foods rich in vitamin A and the B-complex vitamins, such as animal livers, eggs, and carrots.