Squint Strabismus Service

Squint (Strabismus) is misalignment of visual axes two eyes. Causes of strabismus differ in various clinical situations, but it is usually the result of disturbance in the factors responsible for development and maintenance of normal binocular vision.

Binocular vision and coordination of eye movements are not present at birth, but are acquired in early childhood. The process starts after birth and by and large gets completed by 5-6 years. Therefore any obstance to the development of this process may result in strabismus. Binocular vision (seeing simultaneously with both eyes) is required for depth perception.

1st day after surgery 1 Month After Surgery
The factors which can cause squint are

  1. Highly asymmetrical refractive errors
  2. Opacity in central area of the eye
  3. Injury to one eye
  4. Retinal or macular disorders of one eye
  5. Optic nerve Disorders
  6. Paralysis of extra-ocular muscles
  7. Blind Eye.

SQUINT1

Squint correction can make significant improvement in the life of a person. One can have good binocular correction as well as a cosmetic look. It enhance self confidence.

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Squint, also called as cross or lazy eyes, is a condition where your eyes are not properly aligned with each other for a variety of reasons. One or both eyes turn in, out, up or down.

Co-ordination of your eyes and their ability to work together as a team develops in your first six years of life. Failure of your eyes (more precisely, your eye muscles) to adjust properly can lead to crossed eye.

Yes, some squint are hereditary.

Children under 6 years of age are the ones who are most affected, but it often appears between birth and two years of age. It is estimated that 5% of all children have some degree of squint. Although relatively rare, squint sometimes occurs in adults, but usually it is the result of trauma, stroke (paralysis), tumor or other vascular diseases like diabetes & hypertension.

No, this is a common misconception, in fact, the condition may get worse without proper treatment.

Brain will disregard the image from squinting eye with time. The ignored eye will not function normally and will be less used than the other eye. Vision in that eye may decrease (Amblyopia). If Treatment is not given in time, i.e., before 8 years of age, vision will not improve and will remain less throughout life.

Amblyopia is also known as blunted vision, it occurs in a lazy eye secondary to less usage of that eye.

Parents are usually the first ones to notice squint in one or both of their child’s eyes. A complete examination of vision and eyes by a squint specialist is recommended. This can determine if squint is really present.

Treatment of crossed eyes includes glasses, prisms, patching, synoptophore exercises and surgery, patching, synoptophore exercise and surgery depending on the individual case.

One type of squint with plus glass power (Refractive accommodative Esotropia) can be treated with glasses. This type of squint appears at 2 years of life and with correct glasses, either decreases or fully disappears. As soon as glasses are removed the squint reappears. But as the child grows eyeball grows in size and glass power may decrease and squint also may simultaneously decrease. Once the eye power stabilize, Lasik can be done to treat the squint and glass power. Some small Squint (small exotropia) can sometimes get reduced or even converted into latent squint with glasses. If not surgery is required.

The deviation may be constant or it may vary. When a person is concentrating on an image or consciously trying to hide the squint, it can be less, but may be more when they are tried or in deep thought.

Visual & Cosmetic improvement is possible after squint correction. Moreover if left as it child is often exposed to teasing by friends in school and it makes him/her less confident & he or she may even lose interest in school, studies, sports etc. Hence to build up the child’s personality squint surgery is required in addition. The earlier we restore the alignment, better is the chance of binocular vision development.

At birth, an infant’s eyes cannot always directly focus on objects. They may appear to wander even independently. But by 3-4 months an infant’s eyes should develop the ability to focus on small objects and the eyes should be straight or parallel. A six month old infant should be able to focus both near and distance objects.

Consult a squint specialist, immediately. Another important reason for early medical examination is to rule out the presence of serious disease, like tumor.

Always at the earliest especially before 5-6 years so that is the vision is subnormal in one eye,
it can corrected by patching.

SQUINT-TREATMENT

Preferably before 5-6 years of age to restore binocular vision for cosmetic improvement it can be done at any age. Even old people can be operated without any problems.

If the child is operated under general anesthesia, child is discharged by the same day evening. If operated under local anesthesia, they can go home in half an hour after surgery. Overnight stay at hospital is not required.

As early as 3-4 days. Eyes will be slightly red and a bit watery but you can start working normally.

We just strengthen or weaken the muscles to re-align the eyes. Hence it doesn’t change the vision by itself.

Vision in the lazy eye, if already less, will not improve just by squint correction. After surgery, patching of the better eye is required to teach the lazy eye till 8 to 9 years of age.

If vision in both eyes is good, it will not. But if one of the eye has very poor vision, or if totally blind, then in some cases it may drift again after few years.

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