O que é estrabismo e como tratar essa doença ocular

Há poucas doenças oculares que podem ser percebidas por leigos. O estrabismo é uma delas e, por isso, é um dos problemas de visão mais conhecidos. Mesmo assim, ainda há muitos mitos sobre essa condição, que pode causar até mesmo a cegueira em um dos olhos caso não haja um tratamento adequado. Esse distúrbio também é conhecido por outros nomes mais grosseiros, como “vesguice”, “vesgueira” ou “olho torto”.

A principal característica do estrabismo é um desalinhamento dos olhos. Isso significa que o movimento de um olho não acompanha o do outro. Há diversos tipos da doença, que pode ter causas que vão desde um grau elevado de hipermetropia até problemas neurológicos.

Quer entender melhor esse problema ocular? Continue a leitura!

O que é o estrabismo?
O desvio no movimento dos olhos em pacientes de estrabismo é causado principalmente por problemas nos 6 pares de músculos ao redor do globo ocular. É mais comum que os casos surjam ainda na infância (chamado de estrabismo infantil), mas também pode aparecer em pacientes adultos (estrabismo adquirido).

Há quem acredite que a doença seja puramente estética, mas a verdade é que ela pode afetar a visão de forma crítica. Para pacientes adultos, pode haver visão duplicada (diplopia) e torcicolo. Já em casos de estrabismo infantil, frequentemente há também ambliopia. Essa doença é caracterizada pela visão de um dos olhos ser inferior, o que prejudica o desenvolvimento do órgão. É uma condição grave, pois pode haver danos permanentes.

O estrabismo pode ser diagnosticado nos estágios iniciais com exames oftalmológicos de rotina, como o de acuidade visual, o de fundo de olho ou o de oclusão. Grande parte dos diagnósticos feitos na infância são tratáveis, segundo o Conselho Brasileiro de Estrabismo, com melhoria no quadro e na acuidade visual. Por isso, é tão importante fazer um acompanhamento com oftalmopediatra.

Durante os primeiros 4 meses de idade, é normal que o bebê não consiga fixar os olhos em um objeto da maneira como um adulto consegue. Fique atento aos cuidados com a visão na infância.

Há diferentes tipos?
Além da distinção entre estrabismo infantil e adquirido, há diversas classificações da doença de acordo com a alteração no movimento dos olhos.

• Convergente/Esotropia: o olho se voltar para o lado do nariz.
• Divergente/Exotropia: o olho se volta para o lado da orelha.
• Vertical/Hipertropia: o olho se volta para o lado da testa ou da bochecha.
• Alternante: há alternância do olho com desvio (em alguns momentos é o direito, em outros é o esquerdo).
• Intermitente: só há desvio nos movimentos dos olhos em alguns momentos.

Quais são as causas da doença?
No caso do estrabismo infantil, a genética é um fator de risco muito relevante. A doença também pode estar ligada a prematuridade, síndrome de Down, paralisia cerebral e outras condições que afetam o sistema nervoso central.

Além disso, é comum que pacientes com altos graus de hipermetropia desenvolvam estrabismo. Porém, esse distúrbio também pode surgir em decorrência de doenças oculares ou neurológicas, além de lesões, traumas e infecções que afetam o cérebro.

Como funciona o tratamento?
Um dos mitos mais comuns sobre o estrabismo infantil é o de que a doença pode desaparecer com o envelhecimento da criança. Na verdade, quando há um diagnóstico precoce, as chances de cura são muito altas.

O tratamento para estrabismo varia de acordo com a causa da doença. O uso de óculos é uma medida bastante efetiva, principalmente nos casos ligados à hipermetropia. Se há ambliopia, é comum o uso de colírios e tampões para estimular o desenvolvimento do olho que possui a visão inferior.

Para alguns casos, a aplicação de toxina botulínica em um dos músculos é o bastante para promover uma paralisia e alinhar o olho. No entanto, o principal tratamento é a cirurgia. Por meio de pequenos cortes na parte externa do olho, o oftalmologista consegue operar os músculos para corrigir o problema.

Você tem mais dúvidas sobre estrabismo ou quer conhecer melhor os tratamentos da doença? Contamos com um núcleo especializado em estrabismo, com médicos experientes e atenciosos que estão prontos para te atender.

Dr. Lucas Tavares Faria
Dr. Lucas Tavares Faria

Dr. Lucas Tavares Faria é natural de Belo Horizonte, filho de Oftalmologista e descendente da primeira Óptica da cidade. Especialização em Oftalmologia e o fellowship de retina clínica e cirúrgica realizados no Centro Oftalmológico de MG, vem se dedicando ao tratamento clínico e cirúrgico das afecções oculares com foco nas cirurgias de Catarata, Retina e Refrativa.

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