Source: [People's Daily Health Client]
"More than 80% of patients still do not obtain normal binocular visual functions after strabismus correction. For example, although some patients have recovered the tertiary visual function, the range of vision fusion is still small; some patients have recovered stereo vision, but they cannot meet the standards of normal people." Li Li, chief physician of the Department of Ophthalmology of Beijing Children's Hospital, said at the "Eye Improvement and Correctness" Children's Eye Disease Diagnosis and Treatment and Prevention and Control of Children's Eye Diseases, therefore, must not only correct the patient's eye position and improve the appearance through surgery, but also pay attention to the multi-level functional recovery of binocular vision.
Li Li
How does strabismus occur?
Under normal circumstances, the movement of the eyes is coordinated and the eyes can be watched at the same time (when the thing of interest is focused, the eyes will stop and scan what is being watched. These pauses are called "gaze") and the target is imaged in the macular area of the eyes, transmitted to the visual center of the brain, and fused into a single object with a complete three-dimensional sense.
If the child causes incoordinated movement of his eyes due to various neuromuscular diseases, the eyes will not be able to look at the same object at the same time and cannot fuse the objects of both eyes. The stereoscopic vision will be affected, and "strang-eye" will occur.
Why can’t we just correct the eye position when treating strabismus?
Although strabismus patients have normal monocular visual function, since the objects on the binocular retina do not fall in the normal corresponding position and exceed the matching range of the brain, it will seriously affect the coordination relationship between the eyes and the brain, and double vision, confusing , which will cause a series of abnormalities such as visual inhibition, abnormal retinal correspondence, abnormal gaze, and impaired tertiary vision (simultaneous vision, fusion vision, stereo vision) function .
The brain is plastic for life. If timely and appropriate training is carried out in the upright position of both eyes after surgery, it can help patients better restore binocular visual function.
"Therefore, binocular visual rehabilitation training is a key step in strabismus treatment, and binocular visual establishment and stereo vision recovery should occupy a more important position in strabismus treatment. " Director Li Li pointed out that especially for patients with strabismus who have the conditions, the primary goal of treating strabismus should be to repair the patients' integrated reserve ability of binocular visual function.
Professor Li Li further elaborated on the significance of reconstruction of binocular vision function in strabismus treatment. First, reduce the recurrence rate of strabismus and maintain the stability of long-term eye position. "In patients with strabismus with peripheral fusion function, 74% of people can maintain the eye position; among patients with strabismus without fusion function, only 45% of people can maintain the eye position; and after strabismus establishes binocular visual function, the possibility of performing secondary and third surgeries will be significantly reduced."
Second, expand the fusion range and improve the long-term success rate of the surgery; third, eliminate abnormal visual experience after strabismus and improve the quality of life.
"In the treatment of strabismus for children, we should let parents understand that the purpose of surgical treatment is to correct the eye position of the patient, have the opportunity to see objects at the same time, re-establish visual function, especially monocular function of binocular eyes, and ultimately obtain good stereo vision, so that the child can obtain better visual quality after strabismus surgery." Director Li Li said.
What are the binocular visual function training that patients with strabismus can perform?
Director Li Li introduced that due to the different binocular abnormalities caused by various strabismus patients, a personalized plan should be implemented for binocular vision training.
performs desuppression training. In order to overcome diplopia and confuse the public, the brain selectively uses one eye to suppress the other eye. The visual signals emitted by the inhibited eye are ignored by the brain. Through desuppression training, this inhibition effect is eliminated, allowing the patient to restore the ability to visually simultaneously.
Through the training of the regulation function, the adjustment sensitivity of the affected eye can be improved to reduce the occurrence of visual fatigue.
improves the three-level visual function through training of the fusion function. Strab gaze at small angles can change strabismus from dominant to implicit through fusion training, especially for insufficient collection types.
"In addition, although the eye position was corrected after the patient's operation, some patients still had eye position drift after the operation. Therefore, different training methods should be used according to the patient's different situations and personalized training plans can be promoted to promote the reconstruction of binocular visual function." Director Li Li said.
Editor: Mao Yuanyuan
This article comes from [People's Daily Health Client] and only represents the author's views. The national party media information public platform provides information release and dissemination services.
ID: jrtt
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