[Functional treatment of strabismus: theoretical bases--practical rules].

Area of Science:

• Ophthalmology
• Neuroscience
• Neuroplasticity

Context:

• Strabismus treatment has evolved from empirical methods to a scientifically grounded approach.
• Functional treatment of strabismus is framed within the broader context of general functional re-education.
• It addresses both pediatric cases with underdeveloped binocular function and adult cases with lesions.

Purpose:

• To clarify the scientific basis of functional strabismus treatment and dispel doubts.
• To situate functional strabismus treatment within the principles of neuroplasticity and functional re-education.
• To highlight the critical role of patient active participation and psychological factors in treatment success.

Summary:

• Functional recovery in strabismus, regardless of patient age or lesion type, results from central nervous system (CNS) changes driven by neuroplasticity.
• These CNS modifications are slow, often taking years, necessitating sustained and active patient engagement.
• Successful treatment integrates physiological parameters with psychological factors, including motivation, treatment duration, and family support, acknowledging that surgery may be part of the overall plan.

Impact:

• Challenges traditional ophthalmological perspectives on strabismus, emphasizing rehabilitation over purely empirical or surgical interventions.
• Underscores the importance of patient-centered care, active participation, and a multidisciplinary approach in achieving functional recovery.
• Provides a framework for understanding and implementing functional re-education strategies for strabismus, leveraging neurophysiological principles.