Squint and its treatment
How To Be Sure Your Child Has A Squint?
If you see your child squeezing your eyes, or see him or her peering over his or her books, you will often see one of his eyes wandering in another direction, it is then natural to worry about squint. Often you will notice a misalignment of eyes in photographs, or the same will be brought to your attention by friends or family.
What is squint?
Squint, also called strabismus, is an eye condition where the eyes do not look straight ahead or together in the same direction. That is, there is a misalignment of the yes, with one eye looking inwards, outwards, above or below, while the other looks straight ahead.
How common is squint?
Squint is a very common eye disorder and usually presents in childhood, in fact about 1 in 20 children suffer from squint. Most squints develop in toddlers, becoming manifest by the time a child is 3 years old. This is why doctors recommend a comprehensive eye examination in the preschool age group.
About 5 in 100 children aged 5 years have a squint, even though the disease can develop later, and even in adults. The causes for adult onset squint are different for that in children.
How do I know if my child has squint?
Very often, you will notice that the eyes are not aligned. This will be noted first when the child is tired or not paying attention. Very often squinting will be noticed after a fever or any other prolonged illness.
Babies, however, sometimes cross their eyes and it is not an indication of squint always. This squinting usually disappears, decreasing by the time the baby is 2 months of age and gone by 4 months of age. That is, a squint seen in a newborn baby is likely to resolve if it is not permanent, and begins to reduce by 2 months of age and gone by 4 months of age.
All other squints require an eye doctor’s assessments and children usually do not “grow out” of squint.
What are the risk factors for squint?
If you have or have had a squint in your childhood, or have a family history of squint, chances of your child having a squint are higher.
Congenital squint means that the child is born with a squint, which may manifest at birth, or within the first six months of life. The cause for this eye muscle imbalance is unknown.
Refractive errors including shortsightedness (myopia), longsightedness (hypermetropia) and astigmatism result in poor focusing of the image on the retina. This blur means that the eyes attempt to focus by squinting, and the eye may turn as a result of this. This type of squint usually is seen in children more than 2 years of age, especially with hypermetropia, and the eye typically turns inwards (esotropia).
can both be a cause of squint, and a result of the same. Since the eye is suppressed, the stimulus for maintaining the eye in the aligned position is less, resulting in squint.
Sometimes, a squint may be part of more sinister diseases affecting the child. Some important associations are congenital cataract, PHPV, cerebral palsy, Noonan's syndrome, Down's syndrome, hydrocephalus, brain injury or tumor, retinoblastoma etc.
This is why any persistent squint in a child more than six months of age must undergo a comprehensive eye examination by an eye specialist who is especially trained in the management if childhood disorders, especially squint.
What is the treatments for squint?
As is true for most diseases of childhood, an early diagnosis is the key to good results. The treatment options for squint typically involve the following steps:
Correction of refractive error: Wearing appropriate glasses to ensure good vision, after a proper, dilated refraction (refraction under cycloplegia)
Treatment of lazy eye or amblyopia: This treatment must be carried out diligently, if it is present.
Orthoptic exercises, if so decided by the treating doctor
Squint surgery: Surgery is often needed to correct the misalignment of eyes. The reasons for surgery are twofold: to correct the cosmetic appearance and to maintain binocular vision and prevent amblyopia or lazy eye.