FAQs on Squint

What is squinting?
Medically referred to as Strabismus, squint is a visual flaw that leads to misalignment of the eyes. This visual defect causes both the eyes to point in different directions. While one eye may appear pointing straight ahead, the other one may diverge (turn outward), or converge (turn inward). The squinting eye may also turn upward or downward. Such a misalignment could be constant in nature or may occur briefly for multiple times in a day. Also, the condition and occurrence may alternate between both eyes.

What are the primary causes of squint?
A number of factors might cause squinting, such as weakness of eye muscles (that are responsible for eye movement), eye injury, cataract, refractive errors, genetics, cerebral palsy, Down’s syndrome, or hydrocephalus.

What does a squint assessment session include?
An orthoptist may conduct a series of clinical tests to assess the condition of a patient’s eyes. These tests aim at:
  • Identifying the type and severity of squint
  • Assessing refractive errors
  • Testing binocular vision
  • Conducting dilated fundus examination
  • Analysing the fixation pattern
  • Investigating the main cause of squint
Is squint just a cosmetic defect?
No, squinting can be much more than just a cosmetic flaw. It could be related to the problem of diplopia (double vision), decrease of vision, or poor binocular vision (inability to focus on one object with both eyes simultaneously). Squint can also result in gradual loss of peripheral visual field, and fine stereopsis (depth perception).

How can strabismus or squinting be treated?
The treatment options for strabismus or squinting may include:
  • The use of glasses
  • Fixing or embedding prisms on spectacle lenses
  • Wearing an eye patch
  • Botox injection
  • Surgery
Can squint affect infants and young children?
Yes, squint can occur at any age. The cause may not necessarily be known. However, once suspected, accurate assessment of the baby’s condition must be done at the earliest. In some cases, it could be pseudostrabismus (false appearance of crossed eyes or misalignment). It is because of the fact that facial features do not fully develop in infants and toddlers. A wide and flat nose bridge might give an illusion of squint, whichusuallygoes away with age.

What causeschildhood squint?
Congenital squint: It is a condition when a baby is born with misaligned eyes. The problem may become more apparent within the first six months. One of the main reasons could be heredity or family history of squinting.
Far-sightedness or hypermetropia: It refers to problems with near vision. A blurry or poor near vision demands extra efforts in order to view an object placed closer to the eyes. Over-focussing may further lead to the problem of double vision. The eyes unconsciously try to correct the defect by supressing images in one eye. As a result, the child might avoid relying on that eye at all. Effective treatment, at the right time, is crucial so as to prevent squinting or development of amblyopia (lazy eye).
Childhood illnesses: Squint may also be result ofcertain childhood illnesses, such as viral fever, measles, meningitis, etc.
Eye injuries: Injuries or damage caused to eye muscles or nerves might also be responsible for squint.
Hereditary: Strabismus may also be inherited from parents.

What are the ways of correcting squint in children?
To start with, a child’s eyes must the thoroughly examined in order to identify the type and severity of the squint. An orthoptist will assess the vision and fixation pattern and will devise a treatment plan accordingly. The treatment could vary from the use of spectacles, patching, use of eye drops (rarely) or surgery.
The squint caused by hypermetropia (far-sightedness) can be treated withthe use of spectacles. The eye specialist may conduct regular examinations to keep a check on the fluctuations in the power of spectacles and the degree of squint as the child grows. The squint that still remains can also be treated with surgery, if required.
Amblyopia or Lazy eye can be corrected by wearing a patch on the eye that works fine. It is a way of encouraging the weaker eye to be more involved in visual activities.
Surgery is also one of the methods to correct this visual defect. If done at the right way, at the right time, the results can be great.

What leads to the occurrence of squint in adults?
An orthoptist or eye surgeon conducts a thorough examination to diagnose the cause, type, and severity of the squint in adults. There could be two types of squint ─ paralytic or non-paralytic. Paralytic squint is often a result of damage of theextraocular muscles or nerves. The occurrence of the condition is usually sudden, and could be caused due to certain medical issues like diabetes mellitus, hypertension, or brain lesion. However, it couldalso be a birth defect or may develop gradually over the years. On the other hand, non-paralytic is an extraocular muscular imbalance that is rarely sudden and often occur shortly after birth or can be gradual.

Is there a specific age to get the squint corrected?
Anyone who has squint can get it corrected at any point of time. The treatment is not age-specific. However, the type of the treatment may vary for patients from different age groups.

What is the procedure of squint surgery?
The eye socket features six extraocular muscles that control the movement of the eyeball. An eye surgeon usually weakens or strengthens (as per the alignment defect) 2 or more muscles to make the eyeball appear straight. General anaesthesia is given to children before the surgery, while adults usually are made to undergo the surgery on local anaesthesia. It is an outpatient procedure and doesn’t require an overstay stay at the hospital.

What is it that a patient will experience after the surgery?
The operation for squint is an outpatient surgery, which means there is no need for the patient to get admitted for an overnight stay. The patient can remove the eye pad a day post the surgery. Also, the patient is usually prescribes medicated eye drops to be instilled for a couple of weeks after the surgery. Moreover, it doesn’t affect the vision as it is an external surgery. The sutures are self-absorbable and do not need another session in order to be removed. Redness in the eyes may be experienced initially, but the patient may resume his or her daily in a few days.

Can surgery for squint cause double vision?
Surgically aligning the eyes, which have been misaligned for many years in the past, may lead to some degree of double vision. Having said that, the problem of double vision is usually transient.The brain will gradually adapt to the new position or alignment of the eyes.

How many surgeries are usually required to correct squint?
It is common for a patient to undergo more than one surgery in order to get rid of the squint completely. There is nothing to be worried about. The idea is to obtain best alignment results by a couple of fine-tunings. Also at times, a severe squint may require a multiple-staged surgery.
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