Squint is the misalignment or asymmetry of one or both eyes. The very condition is also known as Strabismus, and may occur in any age group, in children as well as in adults, said Dr Priyanka Singh (MBBS, MS, DNB, FAICO), Consultant and Eye Surgeon, Neytra Eye Centre, New Delhi.
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The expert shared that there are a few conditions associated with the ailment. These include:
*A condition where the eye turns inwards – Esotropia.
*A condition where the eye turns outward – Exotropia.
*A condition where the eye turns upwards – Hypertropia.
*A condition where the eye turns downwards -Hypotropia.
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The condition could be “intermittent” which means that it occurs for limited hours in a day, but it some cases it can be “constant” which means its occurrence is persistent throughout the day.
In children – Weak eyesight & Refractive error.
– Non-Refractive squint.
– Neurological disease causing weakness of eye muscles.
– A hereditary disorder, which means that it passes from one to the next generation genetically.
In adults – Its effect include trauma to the nerves supplying eye muscles
– Brain lesions.
– Diabetes and high BP.
In babies of less than 20 weeks, eye-crossing can be present which may disappear with a growing age on its own as vision increases. “If eye-crossing persists beyond the age of 4 months, a visit to an ophthalmologist is a must,” she said.
What happens if the disease progresses?
The major complication of squint is the inability of eye muscles to fixate on a particular object leading to diplopia or double vision in adults. “On the other hand, in children, it can lead to suppression of the affected eye resulting in loss of vision, loss of stereopsis i.e. depth perception and blindness which at the later stages of life is nearly impossible to correct. This condition is called amblyopia or lazy eye,” she explained.
The assessment involves careful history taking and noting the presence of any systemic illness. This is followed by physical assessment and examination of eye. The eyesight is tested and checking of refractive power like Myopia (short-sightedness), Hypermetropia (long-sightedness), and Astigmatism (changes in the corneal shapes) is carried out.
The amount of squint and binocular vision is reviewed, followed by retinal examination. Brain Imaging may be necessary.
The basic treatment is based on 4 Principles and steps associated
1. Correction of Refractive power by: dilated examination and checking refractive power followed by prescribing Glasses or contact lenses.
2. Re-establishment of ocular alignment- either by prisms or by surgery or by Botox injections (in adults) if the ophthalmologists think that only glasses will not correct the ocular alignment
3. Relief of Diplopia & an increase in stereopsis by eye exercises. Home based pencil pushups is an excellent eye exercise (HBPP) to improve the ocular alignment.
4. Correction of Amblyopia (Lazy eye) by patching the normal eye which encourages the weak eye to work harder and improve eyesight.
Alarming signs that parents should see and report:
a) If squint is present at all the times
b) If squint comes and goes
c) Child watching TV or reading books from very near
d) Squeezing of eyes, frequent eye rubbing by a child, the eye blinking or twitching should also be noticed.
Ignoring the signs and symptoms lead to various complications, some of them include
1) Permanent decrement in vision, leading to lazy eyes
2) Increase in squinting
3) Low self-esteem in the later age
4) Chances of fall in adults due to Diplopia (double vision).
– Do not ignore eye symptoms.
– For the health of your eye, it is recommended to go for a yearly eye check-up on a regular basis
– The younger the patient is, the more efficacy the treatment will follow. So it is advisable not to wait until the very last minute. Visit an experienced ophthalmologist when you see any symptoms.
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