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What is it?
Strabismus or Cross-eyes or Squint is a vision problem in which both eyes are not in alignment with each other. Though it is common in infants and children, it can occur at any age. Adults may also develop the condition.
Strabismus can be intermittent or constant.
- Due to weak eye muscles or abnormal nerve impulses to the eye muscles
- Strabismus can accompany some systemic illnesses like diabetes, high blood pressure, multiple sclerosis, myasthenia gravis or thyroid disorders
- Blurred or poor vision due to cataract, corneal scars, glaucoma, refractive errors, optic nerve disease, retinal disease, tumors of the eye etc.
- Brought about by injuries
- Can accompany some systemic illnesses like diabetes, high blood pressure, multiple sclerosis, myasthenia gravis or thyroid disorders.
- Eyes that look misaligned
- Eyes that do not appear to move together
- Frequent blinking or squinting, especially in bright sunlight
- Tilting head to look at things
- Faulty depth perception
- Double vision
- Poor vision in one or both eyes
The evaluation for suspected strabismus usually includes a medical and visual history and a test for visual acuity (how well one sees with each eye). The diagnosis of strabismus is best made with a careful eye examination with the ophthalmologist.
The most common visible sign of Strabismus is that the eye does not appear straight. Sometimes, a child will squint or close one eye in bright sunlight. Faulty depth perception may be present. They may tilt their heads in a specific direction in order to use their eyes together.
Children do not outgrow the squint!
It is important to consult an Ophthalmologist if your child displays these symptoms to determine the appropriate treatment.
Squint surgery and correction in Mumbai, India
Children should be monitored closely during infancy and the preschool years to detect potential eye problems, particularly if a relative has strabismus. Early detection, accurate diagnosis, and proper treatment can cure strabismus. It is recommended that all children be screened for eye health before age 6 months and again between 3 and 5 years of age by a pediatrician or an ophthalmologist.
Routine vision screening for young children includes testing for strabismus, usually using the light reflex for infants, and cover testing for preschool-age children.
The primary goal of treatment is to preserve or restore as much visual function as possible.
Treatment of squint varies depending on the exact type and cause of the strabismus. After a complete eye examination, including a detailed study of the inner parts of the eye, an ophthalmologist can recommend appropriate optical, medical or surgical therapy.
Nearly 40% patients with squint can be cured by spectacles and/or eye exercises. However, a large majority require surgical treatment. The squint operations are very safe and should be done at the earliest. Generally if the eyes are not aligned for more than 6 months in a child, irreversible damage to the three dimensional vision occurs, which is only partly reversible. Squint surgeries are performed successfully even in children as young as 4 months.
Non-surgical treatment – Spectacles and Prisms
Some squints are caused by refractive errors (spectacle powers), usually where one eye has a much higher power than the other. In such cases, squint can be corrected by prescribing proper spectacles.
In children, eye patch may be prescribed for the stronger eye to force the use of the weaker or suppressed eye. Eye drops are used to temporarily blur the vision of the preferred eye. Exercises may be prescribed to strengthen specific eye muscles.
In adult patients double vision caused by small squints can be corrected by incorporating prisms in the spectacles.
Squint eye treatment cost varies depending on condition.
Squint Surgical treatment in Mumbai
Most patients, however, require surgical correction. Surgery is done under general anaesthesia in children and under local anaesthesia in adults.
The aim of the surgery is to tighten or loosen specific eye muscles required to realign the eyes. This is planned for both eyes simultaneously or on one at a time depending on the fitness for the procedure. Occasionally alignment is not achieved with the first surgery and additional surgery is needed.
The eye muscles are situated outside the eyeball and the procedure involves working on the white portion of the eyeball. The eyeball itself is not opened.
The principle of surgery is to weaken the stronger muscle and strengthen the weaker muscle. Either one or several muscles may be operated upon, depending on the type and severity of squint.
Eye is bandaged for one day after surgery.
After surgery, eye drops are prescribed and follow up visits advised.
The treatment does not stop with surgery. Glasses may have to be continued to maintain clarity of vision. Patching therapy may be needed to be continued for some time after the surgery.
With early detection, accurate diagnosis and proper treatment, the prognosis with strabismus is excellent. Treatment before age 8-9 years and especially by 6 years of age gives the best results.