Banlag na Mata at Duling: What is Strabismus (Cross-Eyed and Wall-Eyed)

Strabismus – banlag na mata (cross-eyed) or duling na mata (wall-eyed) – is an eye condition wherein both eyes are not looking in the same direction. 

A person who has strabismus has eyes that do not align with one another. Therefore, they are not looking at the same object at the same time which makes it difficult to get crisp clear images and or recognize how far something is. 

How Does Strabisumus Affect Vision?

In people with normal vision, both eyes aim at the same spot, point, or direction. The separate images that each of the eyes sees are combined by the brain to form one single image. This ability of the brain allows us to see how near and far something is (depth perception) by distinguishing 3-D images. 

In people with strabismus, there is a misalignment in the eyes causing two different images to be sent to the brain. The condition, in adults, can cause blurred or double vision. In young children, where the eye is still developing, they only see the image of the normal eye. In children with banlag na mata or duling na mata, depth perception is lost because the brain learns to suppress the image of the misaligned eye (Amblyopia).

Strabismus is characterized according to the direction of the misaligned eye:

• Esotropia – Inward (Towards the nose)
• Exotropia – Outward (Towards the temples)
• Hypertropia – Up
• Hypotropia – Down

Common types of strabismus include:

• Infantile Esotropia – Usually present at birth or develops within the first six months of life. This disorder is prevalent in children with cerebral palsy or hydrocephalus. 
• Accommodative Esotropia – People with a high amount of farsightedness tend to exert more effort in focusing on nearby objects. As a result, the eyes turn inward.
• Intermittent Exotropia – One eye will fixate on an object while the other eye is gazing outward. The patient will not notice any vision changes but other people will notice the deviation. 

What Causes Banlag na Mata o Duling na Mata?

A lot of factors can cause strabismus. Strabismus can either be the condition itself or a symptom of an underlying disease. Six muscles are keeping the eyes aligned. If a disease or injury causes any damage to one or more of the muscles holding the eye together, a person can develop strabismus. 

Possible causes of strabismus are:

• Eyes aren’t able to function together (poor eye coordination) 
• A significant difference in optical prescription between to eyes. (Left eye has a grade of 0.5 while the other eye has a grade of 3.75 minus)
• Ocular muscle weakness
• Head trauma
• Brain diseases
• Severe farsightedness

Risk Factors of Strabismus

Strabismus can occur in anyone but some people are more prone to developing the disease. 

• Family history. If a person has a relative who has strabismus are more likely to develop it
• Medical conditions. People who have medical conditions especially those related to the brain or the nerves are highly likely to have strabismus.
• Farsightedness or High Grade Error of Refraction. People who have a significant amount of farsightedness can develop strabismus especially if their refractive error goes untreated. 

Symptoms of Strabismus

The key to preventing complications in vision due to banlag or pagkaduling is early detection and treatment especially. If a person or child is manifesting these symptoms, make sure to have them visit an ophthalmologist for proper assessment. 

• Misaligned eyes
• Eyes do not move together
• Double vision
• Tilting of the head to look at things
• Excessive blinking and squinting
• Headaches
• Eye Strain
• Fatigue when reading
• Difficulty reading

Banlag na Mata o Duling na Mata Treatment

The goal of strabismus treatment is to allow normal vision by realigning the eyes. By correcting the misalignment, we prevent the brain from suppressing the image of the misaligned eye. Depending on the cause, there are several treatments for strabismus. 

• Occlusive patching. If strabismus is detected during the early years of childhood, patching the better eye can force the use of the misaligned eye to improve vision. 
• Treatment of eye conditions. Eye conditions such as cataracts can cause the eye to turn. Treating the underlying condition first is a step to treating strabismus.
• Eye muscle exercises. An optometrist or ophthalmologist can facilitate exercises that help to focus both eyes in one direction. 
• Prism glasses. Prism glasses are a special kind of glasses that can induce the misaligned eye to gaze in the correct direction. Prisms alter the light entering the eye, which also lessens or eliminates double vision.
• Eyeglasses. Strabismus is sometimes caused by a refractive error. Wearing the right prescription glasses to correct the refractive error may treat strabismus
• Eye muscle surgery. Strabismus occurs when the muscles holding the eye together are stiff, damaged, or weak. Eye muscle surgery can change the length or position of the muscle as well as loosen or tighten the muscle so that the eyes align with each other. People who undergo eye surgery might have to undergo vision therapy to improve eye coordination and prevent the eyes from getting misaligned again.
• Botox. In some cases, Botox can be used to paralyze the muscles that keep the eyes from aligning properly. The effect of botox can last for a few months but it might be able to help in permanently improving eye alignment. 

Prevention 

Since strabismus can be hereditary, it is difficult to prevent but complications related to the disease is very preventable. If detected and treated early especially in children, strabismus can still be corrected. It is advised to have children undergo an eye check-up before 6 months of age and again between 3-5 years old. 

Key Takeaways

Strabismus is an eye condition where the eyes are misaligned, causing amblyopia and in adults, double vision. Banlag and pagkaduling can be caused by several factors including family history, brain diseases, and severe error of refraction. If detected and treated early complications such as amblyopia and loss of depth perception can be avoided. 

Learn more about Vision Problems here.