Strabismus (Squint)

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Strabismus (Squint)

When both the eyes of a person are not in alignment with each other it is known as squint or strabismus.

Generally,if the child is more than 6 months in age and the eyes have a squint,its needs to be examined by an eye doctor. Irreversible damage to the development of three dimensional (3D)vision can occur if this is not treated in time.If surgery is required it should be done in most cases within six months after the squint is noticed to avoid such irreversible damage.

Nearly one third of the patients with squint can be cured by spectacles and/or eye exercises. However, a large majority require surgical treatment. Squint operations are very safe and should be done at the earliest.

The exact cause of squint is not known.Six muscles control the movement of each eye.

A loss of balance between the muscles of the two eyes leads to deviation of the eye.

Sometimes a refractive error or paralysis of an eye muscle may lead to misalignment of the eye.

Poor vision in an eye because of some other eye disease like cataract, eye tumours, etc. may also cause the eye to deviate. Therefore it is important in all cases of squint, especially in children, to have a thorough eye check up to rule out any other cause of loss of vision.

The ability to see the third dimension to an object i.e. the depth perception is known as 3D vision. This gets affected in children with squint.

Strabismus usually develops in infants and young children,usually by age 3, though it can also develop at a later age. There is a common misconception that a child with strabismus will outgrow the condition. This is not true. In fact, strabismus may get worse without treatment.

Strabismus is classified by the direction the eye turns:

  • Inward turning is called esotropia
  • Outward turning is called exotropia
  • Upward turning is called hypertropia
  • Downward turning is called hypotropia

In children it can cause loss of depth perception (3D vision) and amblyopia, also called as the Lazy Eye Disease (poor development of vision in the squinting eye).

When squint develops in an adult, he or she can have double vision. This is a very annoying symptom which decreases productivity. also there is loss of self-confidence due to cosmetically unattractive appearance.

This is a common eye disease affecting nearly 5-10% of population,also called as amblyopia. In this disease, due to uncorrected refractive error, cataract, squint or other eye diseases, poor vision development is seen in one eye or both. It usually goes undetected unless a vision test is done by an expert. This is why, all children should undergo a vision test so that such diseases can be detected and treated in time. Good results are seen if treated by the age of 7-8 years.

The aim of treating a squint is:

  • To preserve or restore vision. This usually applies in children. Cases of childhood squint when treated in adulthood, give cosmetic correction mainly (though visual improvement is possible in many cases)
  • Straighten the eyes to improve patient’s appearance and restoration of 3D vision are the other aims.

The sooner, the better is the golden rule.
In a child, the treatment of squint and amblyopia should be started as early as possible. Best results are achieved before the age of 7-8 years.
Remember that the child never grows out of squint. A delay in treatment causes rather more damage to the vision.

Treatment of squint generally requires surgery on the eye muscles. One or both eyes may need to be operated upon, depending on the case. Some patients may need glasses, prisms, medication, or even left untreated. At AEH, we do squint surgeries as a routine with our expertise being such that we even get international references, other than those from various parts of India.

Nearly 80-90% patients are successfully corrected in the straight-ahead position with just one surgery. In some patients the surgery may be only partially successful and a second surgical procedure may be required for full correction.

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