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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