STRABISMUS

Squint - Causes and Treatment

Squint, also known as strabismus, is a medical condition in which there is improper alignment of the eyes. In this condition, one eye may be looking straight ahead, while the other eye may be turned inward, outward, upward or downward meaning they don’t work together to look at an object. This condition arises as the result of the imbalance of the muscles that control the movements of the eye. Squint may be present all the time or may appear only when you are stressed or sick. Many people think squint is a permanent condition which cannot be cured. But in reality, most squints can be straightened and completely cured.

A squint disorder may affect a person at any age. A child may be born with a squint or may develop the condition later on. If the condition develops 6-7 weeks after birth it is important to consult a doctor immediately as it may lead to poor vision in the affected eye. Therefore, sooner the treatment starts, the better the results.

Causes of squint

A newborn baby can be born with a squint eye or could develop it  any time in the future. Although the actual cause for the condition is not known, the following factors may play a role in the cause of squint.

• Congenital squint– Some babies are born with squinted eyes, though it may not be noticeable for a few weeks. This condition may be the result of a strong family history of squint. The eye muscles are generally at fault. If a squint is suspected, it is important to get it assessed at the earliest possible time.
• Long-sightedness – Long-sightedness, also known as hypermetropia may lead to a squint in the future as the eyes have to put an effort in order to focus.
• Childhood illness - Squint may also develop as a result of an illness in childhood like viral fever, measles chicken pox etc. This may imply that the child may have had the tendency to squint prior to the illness, but the child was able to resist it and keep the eye straight.
• Nerve damage – Injury to the nerves may lead to a squint.
• Hereditary – There may be a family history of squint.

Treatment for squint

Even though appearance is important, squint is not just a cosmetic problem. In an attempt to avoid double vision, the brain may respond by “switching off” the image from one eye and use only the other eye. If this condition is left untreated, it may result in a lazy eye (Amblyopia) and permanent visual defects.

Therefore, it is important to treat squint at the earliest possible stage. An operation is not the only option for treatment of squint. Treatment of squint varies based on the type and cause of the squint. Some of the common ways for the treatment of squint are:

• Glasses – Glasses are generally the first step of dealing with a squint. If long-sightedness is the cause for the squint ; glasses can be used to correct it.
• Occlusion – Occlusion is the process of patching the good eye to encourage the squinted eye to work better.
• Surgery – This is used to treat congenital squints. Surgery can be performed at any age, but it works best when done in childhood. Therefore early treatment is always the best option. Some cases may require a two-stage surgery. Any double vision after surgery will go away within a few weeks as it may take some time for the brain to adjust to the improved sight.

Exercise – Some exercises may be useful to strengthen the ability of the eyes to work together. It can be helpful for treatment of older children with intermittent squints.

• Botulinum toxin injection – This injection is administered into the eye muscle to weaken them temporarily so that the eyes are better aligned. Although it is temporary, it is very effective for some types of squint in children.

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