Concomitant strabismus

Strabismus during infancy is known as concomitant strabismus. The causes and the basic characteristics of this type of strabismus differ significantly from those of paralytic strabismus. The most important difference is the age of the patient. While concomitant strabismus always develops during infancy, paralytic strabismus can occur at all ages (also during infancy). Mostly the visual system in the brain of patients suffering from concomitant strabismus is already fully developed. Consequently, the images received from both eyes are processed simultaneously, in contrast to the suppressed information from the misaligned eye of paralytic strabismus patients. 

Concomitant strabismus can result from farsightedness (hyperopia), an impairment of the binocular vision or a decreased vision of one eye (amblyopia). However, it may also be inherited.

The treatment of strabismus depends strongly on the point in time of emergence. In case binocular vision is not fully developed during infancy, the misaligned eye has to be “forced” to see properly. This is the only way for the visual centre in the brain to receive the optical stimuli that are essential for its complete development. For this, the healthy eye is covered for a few hours every day (occlusion of one eye).

During strabismus surgery the affected muscles are aligned. Muscle groups that exert too much traction are loosened (muscle recession) and muscles that do not pull enough are tightened (muscle resection).