Squint Eye Condition & Treatment

What is Strabismus / Squint?

Strabismus, or squint, is a condition in which the eyes are not properly aligned with each other. One eye may look straight ahead, while the other eye turns inward, outward, or downward.

Strabismus is a common condition among children. However, it can also occur later in life or during adulthood. Strabismus occurs equally in males and females. It may run in families (inheritance); but there are also many cases where no family history is present.

 

 

What causes Strabismus?

 

The exact cause of strabismus is not fully understood. It is commonly found in children with disorders such as cerebral palsy, Down syndrome, prematurity, hydrocephalus and brain tumours. However, vast majority of children with strabismus do not have these problems. Many of them do have a family history of strabismus. A cataract eye or eye injury that affects vision (severe amblyopia or lazy eye) can also result in strabismus.

 

How do the Eyes Work Together?

 

The brain’s ability to see three-dimensional objects depends on proper alignment of the eyes. When both eyes are properly aligned and aimed at the same target, the visual portion of the brain fuses the forms into a single image. When one eye turns inward, outward, upward, or downward, two different pictures are sent to the brain. This causes loss of depth perception and binocular vision and there may be double vision.

 

Treatment for Esotropia (convergent squint)

 

Treatment depends on the type of esotropia. Accommodative esotropia can be treated successfully by correcting a refractive error with glasses, patching to force the use of the less-preferred eye, or other forms of therapy. Congenital and acquired esotropia usually require surgery for proper and permanent correction.

 

The surgeon makes a small incision in the tissue covering the eye in order to reach the eye muscles. Then either tight inner muscles are placed farther back to weaken their pull, or the loose outer muscles are tightened by shortening their length to allow the eye to move outward. The procedure is usually done under general anesthesia. Recovery time is rapid, and normal activities can usually be resumed within a few days. Following surgery, corrective eyeglasses may be needed and, in some cases, further surgery is required later to keep the eyes straight.

 

As with all surgery, there are some risks, but strabismus surgery is usually a safe and effective operation.

Treatment for Exotropia (divergent squint)

 

A comprehensive eye examination including an ocular motility (eye movement) evaluation and an evaluation of the internal ocular structures will allow an eye doctor to accurately diagnose the exotropia. Although glasses and/or patching therapy, exercises, or prisms may reduce or help control the outward-turning eye in some children, surgery is often required.

 

The most reliable treatment for exotropia is usually eye muscle surgery, but this is often preceded by eye patching and/or eyeglass therapy, especially if amblyopia (lazy eye) is present. This therapy is designed to maximize the existing vision in the weaker eye. In some children, this therapy may eliminate the need for surgery. There is a rare form of exotropia known as “convergence insufficiency” that responds well to therapy. This disorder is characterized by an inability of the eyes to work together when used for near viewing, such as reading. Instead of the eyes focusing together on the near object, one deviates outward.

 

Surgery is usually recommended if the exotropia is present for more than half of each day or if the frequency is increasing over time. Surgery is also indicated if a child has significant exotropia when reading or viewing near objects or if there is evidence that the eyes are losing their ability to work as a single unit (binocular vision). If none of these criteria are met, surgery may be postponed pending simple observation with or without some form of eyeglass and/or patching therapy. In very mild cases, there is a small chance that the exotropia will diminish with time.

 

The surgical procedure for the correction of exotropia involves making a small incision in the tissue covering the eye in order to reach the eye muscles. The appropriate muscles are then repositioned in order to allow the eye to move properly. The procedure is usually done under general anesthesia. Recovery time is rapid, and most people are able to resume normal activities within a few days. Following surgery, corrective eyeglasses may be needed and, in many cases, further surgery is required later to keep the eyes straight.

 

When a child requires surgery, the procedure is usually performed before the child attains school age. This is easier for the child and gives the eyes a better chance to work together. As with all surgery, there are some risks. However, strabismus surgery is usually a safe and effective treatment.

 

This article is contributed by Dr Khoo Boo Kian of Eye Specialist Clinic.

 

Eye Specialist Clinic is a convenient one-stop specialist centre that provides a wide range of services for both adults and children, from ophthalmological eye services, eye screening to even optical services. Our range of services includes paediatric ophthalmology and strabismus, myopia control, cataract surgery, glaucoma surgery, LASIK surgery, oculoplastic/eyelid surgery, diabetic retinopathy, eye screening, various laser treatments, complicated eye problems and retinal surgery etc. Our mission is to deliver the finest eyecare with skill, compassion, and the latest technology.

 

www.eyespecialistclinic.com.sg

 

Address: 290 Orchard Road, Paragon Shopping Centre, #06-01/02/03/04/05, Singapore 238859.
For appointment, please call: (65) 6887 3797 or email: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Health & Beauty Video