Squint Treatment

What is Strabismus/Squint?

Strabismus, also known as crossed or turned eye, is the medical term used when the two eyes are not straight. It occurs in approximately 2 to 4 percent of the population.

What Are the Different Types of Squint ?

There are three common types of squint:

• Crossed eyes A child may be born with this condition, or it may develop within a few months of birth or around two years of age. This is also called esotropia, or convergent squint.
• Divergent eyes A child may be born with this condition, or it may develop later. This is also called exotropia, or divergent squint.
• Vertical squintThe eyes are out of alignment vertically.

Symptoms

• Turned or crossed eye
• Squinting
• Head tilting or turning
• Double vision (in some cases)

Diagnosis

It is possible to examine a child of any age for squint and determine whether the eyes are properly focused. If you are not sure whether your child's eyes are straight, consult your family doctor, who may advise referring the child to an ophthalmologist. The ophthalmologist may use special tests, such as prism testing, to evaluate the alignment of the eyes

Risk Factors

Most commonly, a tendency to have some type of squint is inherited. If any members of your family have had squint, the condition is more likely to develop in your child. Sometimes the condition is due to the eyes being far-sighted and the need for corrective eyeglasses or, occasionally, to some muscle abnormality. Very rarely, squint may be secondary to a serious abnormality inside the eye, such as a cataract or tumour.

What You Can Do to Reduce Risk?

Any cause for poor vision in one eye in a child may lead to squint. There are many causes for poor vision in one eye, but a major concern of ophthalmologists is retinoblastoma, a malignant tumor of the retina. Although it is very rare, in the range of one in 20,000 children, this possibility is why every child with squint should have a pupil dilated examination of the retina as soon as squint is recognized." To detect poor vision in one eye or the other, parents should take children for regular eye examinations according to the following timetable:

• Newborn to 3 months
• 6 months to 1 year
• 3 years (approximately)
• 5 years (approximately)

However, if you or your child notices problems with his or her vision, visit the eye doctor immediately.

Defective binocular vision

Reduction of vision in the turned eye (amblyopia)

A reduction of vision may occur in one eye in squint, especially under certain circumstances, such as late treatment. One such circumstance is if a child is born with straight eyes, but one eye turns in around age two. If this condition is not treated urgently, vision may be reduced to partial sight (legal blindness) in the turned eye. If treatment is begun immediately, however, perfect vision can often be restored.

Treatment

The aim of treatment is to restore good vision to each eye and good binocular vision. Treatment usually includes patching the eye that is always straight to bring the vision up to normal in the turned eye. Glasses may be used, particularly for eyes that are out of focus. Glasses and special drops (phospholine iodide) may also help straighten the eyes. Surgery on the eye muscles is sometimes necessary.

Why is an operation necessary?

Sometimes it is the only way of straightening the eye sufficiently for sight to be restored in the squinting eye. If performed at the appropriate time, results can be very good and satisfactory and Three Dimensional vision can be developed. However, when the results are only cosmetic, they improve the child's appearance only. It is sometimes possible to do more than one operation to achieve the desired results.

How is the operation done?

It involves repositioning the relevant eye muscles on the eye ball. This could mean either shortening or loosening of muscles with surgery.

What happens after operation?

Squint surgery is a day care procedure where the patient is sent home on the day of surgery itself. The eye may appear red after surgery, but this settles down in a few weeks. One should be able to return to school after about 10 days of surgery. If the child wears the spectacles before the operation, spectacle will still be needed after the surgery.