Eyes Apart: Living with strabismus

Photos of rectus eye muscle strabismus surgery in progress

I’ve been asked several times if I know of any photos on the net of strabismus surgery in progress. I came across these photos a few weeks ago. I’ve been hesitant to publish them, because while it may help relieve fears for some to see what is actually being done, others facing the surgery may be traumatized by the photos.

These full size images may disturb you. You can see an illustration rather than an actual photo of strabismus surgery at EyeMDLink. You’ll need to scroll a little past half way down the page to see the graphics.

View the small photos first. If you want to see the larger photos, you can see them by clicking corresponding small photo.

The left photo is entitled Isolating the inferior rectus muscle. There is no further explanation offered for it.

The right photo is entitled Disinserting the medial rectus muscle and here is the explanation that is with the photo:

medial rectus muscle being disinserted following pre-placement of vicryl sutures. A Castroviejo locking forceps is grasping the superior pole of the muscle, while a Manson-Aebli scissors does the cutting. The eyelids are being held by a Cook speculum.

Photo credits:
Scapel by Chris Gander; Isolating the inferior rectus muscle, provided by Rakesh Ahuja, MD, under Creative Commons License through Wikipedia.; Disinserting the medial rectus muscle: Wikipedia

Posted in Strabismus surgery | 1 Comment »

My strabismus: Two lazy eyes like 2 unruly two-year-olds!

Those of us who have strabismus do not like to be referred to as having a lazy eye. We are not lazy. Because our eyes don’t work right, we often have to work much harder to accomplish a task than those who have normal vision.

But if any form of strabismus could be referred to as a lazy eye, it would not be the permanently turned eye that people most often associate with the phrase “lazy eye.” It is so hurtful to many of these people to be labeled with that term. Many have said in the support groups that when people call their eye lazy they feel people are really implying that the person is lazy. Please do not do it!

I have intermittent alternating exotropia, which means one eye or the other will turn out at times. (Since my surgeries, my eye turns are not as noticeable.) Our eyes are not lazy either, but in the safety of our support group, where we all understand, I used the term “lazy eyes” recently to describe the battle we face. Here is the description I shared:

My strabismus is more like two lazy eyes that neither one wants to carry the load, but both want to be the boss because they can’t get along with each other. My eyes are like two unruly two year olds, and my brain is like the mother that is always telling her children to stop fighting and play nice together and share. I suppose the therapy is like discipline…argh. My brain has to insist that my eyes do it, but my brain doesn’t like it much either. Like the parent who says, this discipline hurts me more than you, maybe?

This is the challenge we face every day. Hopefully my sharing it here will help you see just a little of that battle also, and to reach out to someone with strabismus. Those with permanently turned eyes usually have very little control over the turned eye. And those of us with intermittent or alternating eye turns work very hard just in order to keep our eyes focused long enough to see.

I see posts in our strabismus groups or our comments areas almost daily from people who have been wounded because of social isolation, or taunts and teasing about their “lazy eye.” People with strabismus have difficulty making eye contact. Not only are they embarrassed about their turned eye, but when they look at you it often appears that they are looking away from you.

You can make a difference for these people! One of the best ways to show that you care about a person with an eye that turns is simply to look them in the eye as you talk with them. It may appear that they are looking over your shoulder or at something else in the room. But they are not. You are the one looking around the room, because you don’t understand how their eyes work. They are looking at you!

Photo credit: martina perhat

Posted in Help and find help, Lois' story, Social trauma, The way we see | 20 Comments »

President Abraham Lincoln: A great man with a drifting eye

President Abraham Lincoln had a rugged, somewhat homely look. Now scientists say that Lincoln’s face, which it’s said was often the brunt of ridicule, was distorted due to a medical condition called cranial facial microsomia. The result was that the left side of his face, including the eye socket, was much smaller than the right.

According to Dr. Ronald Fishman, an Ophthalmologist who led a study published in the August issue of the Archives of Ophthalmology, “Lincoln’s contemporaries noted his left eye at times drifted upward independently of his right eye.” Fishman also said that, “Lincoln noticed double vision only occasionally and it did not bother him a great deal.” The strabismus is thought to have been caused by a displaced eye muscle related to the smaller left eye socket.

Lincoln was kicked in the head by a horse when he was young, but it is not known if his facial disfigurment and strabismus were caused by that trauma, or if they were a developmental defect.

What we do know is that history tells us that our 16th president, Abraham Lincoln, was one of the most loved American presidents; yet he had a drifting eye, a misshapen face, and no formal education. Lincoln was not without his opponents. In fact opposition led to his assassination at the age of 56. But history remembers him as the president who led our country through the Civil War, stood tall against slavery, and firmly upheld that “all men are created equal;” yet was a humble man who did not consider himself better than the people he served.

Abraham Lincoln (Feb. 12, 1809 – Apr. 15, 1865) was the 16th president of the United States of America.

References:
Lincoln’s Craniofacial Microsomia, Ronald S. Fishman, MD, Archives of Ophthalmology, August 2007.

Abraham Lincoln, Wikipedia.

Scientists on Abraham Lincoln’s Face Defect, Science QJ Net.

Photo credit: Apples 4 the Teacher

Posted in Education, Inspirations | No Comments »

Drugs for strabismus and amblyopia: Connecting our eyes again

[See end of article for photo credit.]
Wouldn’t it be super if we could just pop a pill and it would do something in our brains to connect our eyes properly again? Recent comments on our January 5, 2006, post shared a brief personal experience regarding an antidepressant that seemed to help, as well as a link to a research article related to drug treatment for strabismus and amblyopia.

The research article mentions three classes of drugs that might have a role in the treatment. Most of us have heard of Botox injections (botulinum toxin) which is the first class the article lists. The second class is the “autonomic agents (atropine, miotics).” These drugs are said to help by “by altering the refractive state of the treated eye” as an alternative to optical correction (miotics) and patching (atropine). For help in understanding the “refractive state” mentioned in the article, I found this item:
Eye Anatomy – Refractive.

The third class is “the neurotransmitter precursor levodopa and the related compound citicoline” which the article says, “have been demonstrated to improve vision in amblyopic eyes.” The item goes on to say that the “therapeutic role of these centrally acting agents in the clinical management of amblyopia remains unproven.” You can read the entire article on Pub Med:
The role of drug treatment in children with strabismus and amblyopia.

In several interesting comments to our item posted to Eyes Apart on January 5, 2006, entitled New treatment for adults with amblyopia, “david” has been sharing his search for help with amblyopia. Recently “david” commented that he had been taking an antidepressant, Wellbutrin SR 150mg for 2 weeks and that he did a search because the Wellbutrin seemed to be helping his drifting eye. Read the rest of this entry »

Posted in Medications | 2 Comments »

Famous people with strabismus: Hall of Fame

Hall of Fame is a new category at Eyes Apart. I’ve already featured several famous people with strabismus on the site. I’m adding them to this category, and I plan to add more from time to time.

The photo on this page is a Rembrandt painting. I have featured him in the past using a self portrait that showed his strabismus. But I wanted to include a piece of his art in the Hall of Fame, so I thought it fitting to use it for the introduction to the new category. I’ve got several famous people in the lineup for the hall of fame already, but if you’d like to suggest a name or write a piece for the Strabismus Hall of Fame, you can email me here.

Many of you deserve special recognition also, and I’m glad to publish stories of non-famous people with strabismus. If you have an inspirational story to share about strabismus, you can email me also. But the Hall of Fame is reserved for famous people with strabismus. Those who have made it to fame in spite of their strabismus inspire us all to push for the top in whatever area we’re in. We may never be famous, and we may not even want to be, but we can be achievers and do our best, and that is what counts.

Photo Credit: Web Museum, Paris.

Posted in Hall of Fame | 1 Comment »