CHILDHOOD AND ADULT STRABISMUS SQUINT

What is a Squint?

Normally, both the eyes should look central and move together. When the brain fails to keep them aligned a Squint or Strabismus is seen. The Squint can be present all the time or is variable in a child throughout the day, known as a Constant Squint or Intermittent.

What are the different types of Squint?

It is divided into Horizontal Squint & Vertical Squint

Horizontal Squint includes

Esotropia
Exotropia

Vertical Squint includes

Hypertropia
Hypotropia

What causes a Squint?

It is the result of abnormality in the connection between the nerves and the muscle. We still do not fully understand the reason, but the control centers in the brain responsible for keeping the eyes straight or aligned are faulty or weak. Sometimes, if the Squint is constant in one eye, it can be due to abnormality in the eye such as a Cataract and in very rare cases a tumor.

Can Squint cause poor vision?

A misaligned eye can cause poor vision or [Amblyopia]. When the eyes are not aligned, the brain receives two different images. This causes confusion for the brain. And in order to avoid double vision or Diplopia, the brain shuts the image from one eye—usually the misaligned eye causing maldevelopment of vision.

Can Squint be corrected on its own?

When I see patients with Squint, they say they have often been told by doctors and family members that any Squint does not need treatment as most of them get better with age. Unfortunately, this is not correct as all Squint need to be evaluated and treated by a trained Pediatric Ophthalmologist who has experience in dealing with these conditions.

What is the treatment of a Squint?

The ultimate goal of treatment is to improve and maintain the eye alignment as the eyes work better when they move together, giving us 3D or binocular vision.

All children and adults need to be evaluated for treatment as the majority of them require either prescription glasses or need to undergo surgery for treatment. When you see an ophthalmologist, a detailed examination of the eyes is done with Cycloplegia Refraction and evaluation of the back of the eye to see for any abnormality.

Above child 5 years of age presented to me with Esotropia. Glasses did not improve the vision- she underwent surgery to correct the before and after surgery

One year old with Alternating Esotopia underwent surgery to both eyes with good post operative outcome

A 5 year old with a left double elevator palsy. Left eye has a large hypertrophic pre op. Underwent surgery to the left upper eye muscle with a good outcome immediately post op photograph enjoying a meal

A young man with a large angle exotropia, quite bothered with the appearance. Underwent surgery with adjustable sutures for optimal outcome.