What is squint (strabismus)?
The medical terminology for squint is 'strabismus'. It defines a condition in which one eye of the patient does not move in coordination with the other, but moves in a different direction than the other.
One eye may turn inward, outward, upward, or downward as the other may look forward toward.
One eye that does not look straight ahead but faces inward, outward, upward, or downward is the most visible indication of a squint. Minor squints are even less noticeable.
The patient may experience blurring or doubling of vision in a squint. But this problem may not be identifiable by young children and babies.
It is not always clear what causes a squint. In congenital squinting, often squints run in families, and a baby with the condition can be born.
Squints in childhood are due to some medical conditions or may be due to some sight-related problems such as refractive errors.
When the patient's eye is unable to focus on the light that is passing through the lens, it causes squint. This is a refractive defect. These include:
- An issue impacting the ability to see things from afar
- A sight problem which affects the ability to see objects close-up
- Blurring of vision due to uneven corneal curvature
Treatments for squints
Treatment outcome for squints depends on how fast the assessment has been done and treatment initiated.
- Alternatives include:
- Patients with lazy eyes require a patch over the defective eye. The majority of them only require regular follow-up visits for assessments.
- The benefits of surgery for squint are:
- Improved appearance (often)
- Increased peripheral (side) vision (often)
- Improved depth perception (sometimes)
- Improved abnormal head position (occasionally)
Squint surgery is a very common eye operation. It usually involves tightening or moving one or more of the outside eye muscles which move the eye. The muscles attach to the eye front just under the conjunctiva. During the surgery, the eyes remained in the socket. Squint surgery is almost always a day-case operation.
- There are two types of surgeries:
Older children and adults undergo adjustable surgery and the stitches are maneuverable just after the surgery in the waking state. There are chances of regression of this condition in later years.
Preoperative tests for strabismus surgery
The physician uses sensorimotor examination to check the alignment of the eyes and evaluation of the muscles that are important in the causation of strabismus. This helps the physician in identifying the muscle which is causing the problem and the problem is rectified. Prisms help in evaluating the degree of strabismus. Examination guides the surgical planning. The surgeon operates both eyes even if there is a problem with one eye only. Initial surgery guides the reoperations.
Preparing for squint surgery
What happens during squint surgery:
- The surgeon takes around 1 hour or even less to perform the surgery under general anesthesia. Using a lid speculum, the surgeon cuts the muscles attached to the eyes and then repositions these muscles to the new location. Absorbable sutures help in stitching the muscles with the eye. After the preliminary surgery, additional adjustments are possible after the patient wakes from the effects of anesthesia.
After squint surgery
- The surgeon puts a safety pad over the operated eye, which is removed in the next 24 hours or while discharging from the hospital. Analgesics are prescribed for pain and eyedrops for healing.
Risk factors for squint
- Risks of the surgery:
- There are only minor adverse effects of the surgery, none of any serious level.
- Returning to normal activities:
- Reading and watching television can be done as per the patient’s assessment. Driving is not allowed for at least 2 to 3 days or till the time the patient has double vision. Swimming is disallowed for at least 7 days. They need to be protected from dust, shampoo, face paints, etc.
- Patients can wear the existing spectacle, but permission from the operating surgeon is required for wearing the contact lenses
The patient needs to make regular follow-up visits as advised by the surgeon. In case of any adverse event the patient should make a visit to the surgeon.