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‘Pagkaduling at pagkabanlag’: A parent’s guide to strabismus

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Children can still have their eyes checked by Asian Eye’s pediatric eye specialists despite the COVID-19 pandemicChildren can still have their eyes checked by Asian Eye’s pediatric eye specialists despite the COVID-19 pandemicStrabismus happens when the eyes are wandering or not looking in the same direction.

One eye looks straight ahead, while the other eye turns inward (cross-eyed or pagkaduling) or outward (walleyed or pagkabanlag). While pagkaduling and pagkabanlag are the most common ones, there are cases where the other eye may turn upward (hypertropia) or downward (hypotropia).

According to Asian Eye Institute pediatric ophthalmologist and adult strabismus specialist Dr. Norman Fajardo, strabismus is a common eye condition in children. However, the condition may affect adults as well.

How does this happen?

Fajardo explained that there are six muscles for each eye that control the movements and alignment of the eyes.

“These muscles are attached to the outside of the eye and are controlled by the brain. All these muscles should work and move together—to the left, right, up and down. If there is one or two muscles that don’t move well, strabismus may develop.”

Aside from eye muscles, strabismus is associated with an uncorrected high refractive error. In addition, previous eye injuries, eye problems that result in poor vision like cataracts, and disorders that affect the brain such as cerebral palsy, Down syndrome and stroke may put you at risk for this eye condition.

What are the warning signs?

Parents are strongly urged to observe their children and be proactive when it comes to their eye health.

Fajardo noted: “Most kids don’t complain about what they are experiencing because they think it’s normal. They think having blurred vision is normal because they can’t compare it with their friends’ or siblings’ vision, or they don’t have any alternative experience to relate it with.”

The main sign of strabismus is the misalignment of the eyes. Those with less obvious misalignment are likely to experience double vision, headaches and eyestrain.

What do parents need to do?

When parents start to notice signs and symptoms, it’s best to get the child’s eyes checked by a pediatric eye specialist.

“Around 80% of children’s learning is through their vision,” Fajardo shared. “So the main goal is to protect their vision to aid their learning and development. So when we detect and treat it early, their treatment is likely to be more successful. We’re also able to prevent complications like problems in depth perception or 3D vision and even lazy eye.”

Treatment

A routine comprehensive eye exam will ensure that children have clear, healthy vision. It is important to get their eyes screened at six months old and get checked at three years old or before they start going to school. A Hirschberg test can even be conducted at home.

“It’s a light reflex test to quickly check the child’s eye alignment. Parents don’t need to worry about it because we will be guiding them how to do it,” Fajardo said.

Patients with strabismus may be recommended to wear prescription eyeglasses or eyeglasses with prisms, or undergo active vision therapy or eye muscle surgery. These treatments focus on improving eye alignment and coordination.

Need to get your or your child’s eyes checked? Asian Eye has pediatric eye and adult strabismus specialists, and has clinics in Rockwell Makati, TriNoma, SM Mall of Asia and Commercenter Alabang. Book a comprehensive eye checkup at 8898-2020 or This email address is being protected from spambots. You need JavaScript enabled to view it. . You may try the teleconsultation service by calling or texting 0917- 8009103. (Story/Photos by: Charizze Henson)

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