SQUINT(Crossed Eyes)

What is SQUINT ?

Normally both of our eyes are perfectly aligned and move in tandem with each other in all directions of viewing.

When one or both eyes do not  move synchronously , are turned inwards or turned outwards  , is called Squint.

What are the causes of Squint ?

Could be congenital , by birth.

Could be refractive , due to a high plus or minus number.

Could be due to paralysis of one or more muscles that move our eyes.

What are the two most important things to be kept in mind in cases of squint ?

Refractive error ( Spectacle number ).

Visual acuity . 

Both of these things are difficult to check and determine in very young children.

What is Pseudo-Squint ?

In very young children the eyes may appear squinty due to the broad nasal bridge. This squint is not real but  only appears to be so. This disappears at the child grows up.

What is the medical treatment of squint ?

Every child of squint needs to be checked for spectacle number and for vision. This may be difficult to do in very young children and needs a very persistent approach by the eye surgeon by teaming up with the parents to take care of the child.

Glasses if required need to be worn by the child.

Vision stimulation therapy , both active and passive needs to be carried out. Many patients improve with this treatment alone.

This needs to be continued until the doctor feels that delaying any further may severly jeopardise the visual development of the child . Then a decison is taken to treat the squint surgically.

What is surgical treatment of squint ?

Many squints can be treated quite adequately with surgery. During surgery , the surgeon may weaken or strengthen the muscles that move our eyeball.

If vision of both eyes is good (with or without glasses) , there is a very good chance of near normal correction.

If vision of one or both eyes is weak , the correction may not be perfect but still a lot of improvement is possible.

More than one surgery may be required for surgical correction of squint.

Glasses if required , must be continued even after squint surgery .

In cases of lazy eye , vision stimulating exercises are advised for improvement of vision.

Can all squints be treated perfectly with surgery ?

It is much harder to treat squints caused due to paralysis of one or more muscles that move the eyeball or in cases where there is abnormal innervation of the muscles.

In such cases , often our goal in such cases is to correct the abnormal  head position associated with this squint.

At what age should surgery be carried out for squint ?

Surgical correction for squint should preferably be carried out by the time the children start going to school or even earlier. Delaying it any further may cause irrepairable visual problems.