Many people think that squint is a permanent condition and cannot be corrected. But the truth is that eyes can be straightened at any age.
Commonly known as “Strabismus”, where the eyes are not aligned in the same direction, this can be present only part of the time, in one or alternating between two eyes. The squinting may turn in (converge), turn out (diverge) or sometimes turn up or down.
You might be wondering what causes it- Is it by birth, accidental, hereditary- Our eye expert, Dr. Parul Sharma says, it arises due to an incorrect balance of muscles, refractive error, childhood illnesses, nerve palsy and several other reasons.
What about Childhood Squint?
If the squint is suspected, then it is necessary to evaluate the baby at the earliest. Sometimes a “Pseudo Squint” may be present due to a wide gap between the eyes, flat nose bridge where the eyes do appear misaligned but do not actually have the squint. The causes are:
- Congenital Squint- These children are born with a squint though it may not be obvious for few weeks. A strong family history could be present.In all children, the vision and need for spectacles have to be assessed.
- Long Sightedness or Hypermetropia- As the child cannot focus well, he has to put extra effort to focus, which can cause a double vision. To avoid this, the image in one eye is suppressed unconsciously and in turn, the child avoids using that eye. If left untreated not only does the eye deviate but also becomes a lazy Eye (Amblyopia).
- Childhood illnesses- Squint may also develop because of viral fever, measles, meningitis etc
Is it only a Cosmetic Problem?
Not always. It can be associated with decreased vision or diplopia (double vision). Loss of binocular vision (ability to use the Eyes together) can lead to loss of fine stereopsis (depth perception) and peripheral visual field.
How can the Squint be assessed?
It is assessed by various orthoptics test, the aim of which is to:
- Establish the amount and type of Squint
- Assess how well can the Child / Adult see = refraction
- Test for Binocular Vision
- Fundus examination including fixation pattern
What is the treatment for Childhood Squint, will he need to wear Spectacles or undergo Surgery?
The child is thoroughly assessed to know the type of squint as it is very important to note the vision and fixation pattern in both eyes. The spectacle power and degree of squint will be examined till he grows up. Any residual squint that may not be corrected by spectacle can be corrected by surgery. Few eye diseases like:
Amblyopia / Lazy Eye- This is treated by Patching/Occluding the good eye. The weaker eye is encouraged to work harder with visual activities such as colouring and reading while a patch is on.
Surgery: - Sometimes this is the only choice to straighten the eye. If done at appropriate time results can be very good and 3D vision can develop.
Will more than one Surgery be required?
It is not uncommon for more than one operation to be necessary. This does not mean that something has gone wrong but that fine-tuning is needed to obtain the best straight alignment. Sometimes the Squint is too Large and hence 2-stage Surgery is planned.
Will straightening my eyes after all these years cause me to see double?
Double Vision may occur after straightening eyes that have been out of alignment for many years. However, it is generally a transient problem, lasting only a few weeks until the brain adapts to the new eye Position.
What happens after the Operation?
It is a day Care Surgery with no hospitalisation. The eye pad is removed the next day and eyedrops are instilled a couple of times during the next weeks. Since it is an external surgery there is no effect on the vision. Most of the times external sutures are absorbable and do not have to be removed. Though the eyes may be red initially but a person can join back his office in a couple of days.