CONTACT: BECKY SOGLIN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-6660; fax (319) 335-8034
Release: Jan. 10, 2000
UI treats adults for eye problems often thought untreatable
IOWA CITY, Iowa -- Strabismus and certain eye muscle conditions can cause
considerable functional and social problems for affected people. For years,
John Danielson, 57, of Indianola, had a less common condition in which his
eyes would shake and he needed to markedly turn his head to the side in order
to see well.
Reading was difficult, and the condition made Danielson self-conscious when
he had to speak publicly. However, more adults like Danielson whose eye problems
were not treated in childhood are finding help from University of Iowa Health
On referral from Thomas Brown, M.D., a West Des Moines ophthalmologist,
Danielson had corrective surgery at the UI last October. He now enjoys vision
that allows him to read with ease and look directly into his wife's and five
children's eyes while keeping his head straight.
"I reaped some major benefits," said Danielson, who is a communications
engineer for the Iowa Communications Network. "The treatment really improved
my quality of vision. I noticed the difference within a couple of hours after
William E. Scott, M.D., professor of ophthalmology and a nationally recognized
strabismus researcher, performed the operation -- one of nearly 450 strabismus
cases seen each year by physicians in the UI department of ophthalmology and
visual sciences. In a three-hour outpatient procedure, Scott cut muscles in
Danielson's eyeballs and reattached them to correct the marked head turning
problem. On his way home later that day, Danielson read a magazine in the
"Correcting John's abnormal head posture made a great difference in
his life," Scott said. "The treatment is not simply cosmetic but
restorative. Eye muscle surgery can provide functional gains, restoring the
field of vision or simultaneous perception as in the case of cross-eye or
In strabismus, poor eye muscle control causes a lack of coordinated eye
movement. The eyes turn inward in convergent strabismus, causing "cross-eye."
In divergent strabismus, the eyes diverge, causing "walleye." Other
forms of strabismus can cause double vision. Left untreated, a child may favor
the unaffected eye, which can cause the other eye to get even worse. Strabismus
affects up to 4 percent of the general population.
A good number of adults with strabismus were born with eye alignment deformities
or developed them later in life. For various reasons adults are often told
the condition cannot be treated, or treatments are not available at their
age, Scott said. However, many cases now are treatable.
"It's a myth that strabismus can't be corrected with good results even
in adults who grew up with the condition," Scott said. "We may not
be able to correct a condition 100 percent, but upon evaluation, we can let
a patient know what is possible."
Danielson's parents took him to the UI in the 1950, when he was 8, but treatments
were not available then, and he had to learn how to cope with the disability.
"I would turn my head to where the eyes were steady and quiet,"
he said. Although his distance vision was not a problem, his close vision
activities were compromised enough to affect his everyday life. He recalls
that schools in the 1950 did not really know how to help students like him.
Scott said that studies associate stress with strabismus. In our culture
where direct eye contact is expected, a schoolteacher or work colleague may
mistake a "sideways" look for inattention or even disrespect.
Today, nearly 40 percent of patients treated for strabismus at the UI are
age 9 or older. Strabismus is hereditary but also can be caused by accidents,
such as a motor vehicle crash, in which a person takes a severe blow to the
head. In rare cases, strabismus can be a precursor to a more serious condition
such as eye tumors.
As with most medical procedures, there are a few risks and side effects
to strabismus surgery. Scott said physicians are careful to take precautions
to prevent infection in a patient's eyes and, in some cases, a second or even
third procedure is necessary. After surgery, the eyes are usually sensitive
to light, feel gritty and sore due to stitches, and appear bloodshot. It can
take up to one year for the "white" of the eye to fully regain its
Scott said some individuals who receive strabismus treatment complain of
double vision after surgery, but a study found that less than 1 percent had
the same complaint three years later.
Danielson, who has no double-vision problem, said the post-surgery discomforts
were worth it to stabilize his vision.
"There was some adjustment since I had been looking off to the side
for 57 years," he said, "but now I don't have to think about holding
my head a certain way to see straight. It's fantastic."
As with all medical conditions involving the eye, talk with your ophthalmologist
or other eye care professional if you have strabismus or any sudden onset
For more information about strabismus treatment at the UI, call (319) 356-2859.
University of Iowa Health Care describes the partnership between the
UI College of Medicine and the UI Hospitals and Clinics and the patient care,
medical education and research programs and services they provide.