Strabismus: Severity, Treatment Options, and Military Eligibility

Q: Strabismus: Severity, Treatment Options, and Military Eligibility

Hello： A 50 prism diopter is considered a significant angle, but the doctor mentioned that your control is quite good, which means you can rely on your own strength to align your eyes back to the proper position. <br>However, when you are fatigued, you may experience strabismus.

Strabismus issues

Hello, Doctor Gao: I apologize for bothering you again.
Today I went to see a doctor and was diagnosed with strabismus.
The doctor mentioned that I have 50 degrees of strabismus when looking up close and 30 degrees when looking far away.
I would like to ask if this is considered severe? The doctor said my control is good, so surgery is not necessary yet, but he mentioned that my control could potentially weaken.
I would like to ask the doctor: 1.
Would wearing glasses help improve my condition? 2.
Is my strabismus caused by disparity? 3.
If it reaches 57 degrees, will I be disqualified from military service? Thank you, Doctor.

Lin, 10~19 year old female. Ask Date: 2023/03/10

Dr. Gao Pilin reply Ophthalmology

Hello: A 50 prism diopter is considered a significant angle, but the doctor mentioned that your control is quite good, which means you can rely on your own strength to align your eyes back to the proper position.
However, when you are fatigued, you may experience strabismus.
If it is not currently affecting your daily life, surgery may not be necessary.

1.
Wearing glasses can help correct myopia and hyperopia, but their effectiveness in correcting strabismus is limited.
Glasses may help you see objects more clearly, but they do not directly correct strabismus.

2.
In some cases, strabismus may be related to a difference in refractive error between the two eyes, a condition known as refractive strabismus.
Refractive strabismus typically occurs in children and may be due to poor eye development or a significant difference in refractive power between the eyes.
Your right eye has -1.00 diopters of myopia and -3.75 diopters of astigmatism, while your left eye has -2.25 diopters of myopia and -0.75 diopters of astigmatism.
This degree of refractive error should not be sufficient to cause strabismus.

3.
According to positional regulations, individuals with alternating strabismus exceeding 57 prism diopters are exempt from certain requirements.

Reply Date: 2023/03/10

More Info

Strabismus, commonly known as squint or crossed eyes, is a condition where the eyes do not properly align with each other when looking at an object. It can manifest in various forms, including esotropia (inward turning), exotropia (outward turning), and hypertropia (upward turning). The severity of strabismus is often measured in degrees, which indicates the angle of deviation from normal alignment. In your case, you have a near deviation of 50 degrees and a far deviation of 30 degrees.
1. Severity Assessment: The severity of strabismus can vary widely among individuals. A deviation of 50 degrees for near vision is considered significant, while 30 degrees for distance vision is less severe but still noteworthy. The fact that your doctor mentioned you have good control suggests that your brain is effectively compensating for the misalignment to some extent. However, it is important to monitor this condition, as the control can change over time, potentially leading to amblyopia (lazy eye) or worsening of the strabismus.

2. Eyeglasses and Treatment Options: Wearing glasses can sometimes help improve strabismus, especially if there is a refractive error (like nearsightedness or farsightedness) contributing to the condition. Glasses may not correct the misalignment but can enhance visual clarity and comfort. In some cases, prism lenses are used to help align the images seen by each eye, making it easier for the brain to fuse them into a single image. However, if the strabismus is due to muscle imbalance or neurological issues, surgical intervention may be necessary.
3. Causes of Strabismus: Strabismus can be caused by various factors, including muscle imbalances, neurological conditions, or refractive errors. It is not solely due to "visual disparity" but can involve how the brain processes visual information from each eye. If your strabismus is primarily due to muscle control issues rather than refractive errors, corrective lenses may have limited effectiveness.

4. Military Eligibility: Regarding military eligibility, standards can vary by country and branch of service. Generally, a significant strabismus (often defined as greater than 20-30 degrees) can disqualify an individual from military service due to concerns about depth perception and overall visual acuity. If your strabismus were to worsen to 57 degrees, it could indeed impact your eligibility. It is advisable to consult with a military recruiter or medical officer for specific guidelines related to your situation.

In summary, while your current strabismus is significant, the good control you have is a positive sign. Glasses may help improve your vision, but the underlying cause of the strabismus will dictate the best treatment approach. Regular follow-ups with your eye care provider are essential to monitor any changes in your condition and to discuss potential interventions if necessary. If you have concerns about military service, it would be prudent to seek guidance from the appropriate military medical personnel.

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