What is a squint eye and how can it be corrected?

Overview

A squint or strabismus occurs when both the eyes of the patient do not align properly. While one eye functions properly and displays normal behavior while focusing, the other eye tends to deviate from the expected position.

Usually, this happens when the extraocular muscles, which control the movement of the eyes and eyelids, are unable to function in tandem. As a result, neither eye can focus on the same point at the same time. This deformity can also occur if the eyes cannot coordinate properly due to a complication within the nervous system. Strabismus disrupts binocular vision which hampers the patient’s depth perception.

In India, the general incidence rate of strabismus, or squint eye, is between 4% and 6%. Premature newborns, on the other hand, have a incidence rate of 30% to 40%.

What is squint eye?

Squint, also known as strabismus, is a condition in which both the eyes are unable to focus on the same direction at the same time. In such instances, while one eye may be able to focus on an object being observed, the second eye may turn inwards, outwards, upwards, or downwards at the same time.

This misalignment may be permanent or may appear on occasion. Squint is most typically seen in children; however, it can also manifest in adults. Most strabismus are the results of an abnormality of the neuromuscular control of eye movement. However, if left untreated it can lead to amblyopia, wherein the brain starts ignoring signals from the afflicted eye. Adult squints are often caused by secondary factors such as trauma, brain lesions, looking at a computer screen for long periods of time, etc., and their treatment differs from that of children.

How are squints classified?

Here is a quick checklist of how squints are classified:

  1. Based on direction of the eye deviation

1. Esotropia: in this case, one eye deviates inwards, towards the nose.
2. Exotropia: in this condition, the eye tends to deviate outwards.
3. Hypertropia: this condition leads to the eye deviating upwards.
4. Hypotropia: in this case the eye deviates downwards.

2. Based on the duration of the squint

1. Constant squint – The squint is always present
2. Intermittent squint – The squint occurs occasionally

3. Based on the occurrence of squint

1. Manifest squint – The squint occurs when the eyes are open.
2. Latent squint – The squint occurs when the eyes are closed.

4. By the severity of the squint

1. Concomitant squint – The angle of the squint remains same when seen from any direction.
2. Non-comitant squint – The angle of the squint varies according to the direction in which the eyes are turned.

5. By age

Most squints appear during the first three years of life. However, some of them may also appear in older children and adults. The squints in older children and adults are usually caused by secondary reasons such trauma, injury, brain lesions, tumors, and more.

Here is an easy guide of symptoms that can help you identify whether you or somebody you know is suffering from squint eye:

• Eyes move independently of each other.
• Crossed eyes
• Double vision
• Peripheral vision impairment or loss of vision in one eye
• Depth perception issues

When should you visit a doctor?

All cases of squint necessitate a visit to the doctor, since they might signal a deeper underlying problem, such as tumor in rare cases. However, if the squint progresses to amblyopia or lazy eye, it is essential to visit a doctor immediately.

Medical experts at Apollo can help you chart a path to recovery.

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What are the causes of squint eye?

Problems in the eye muscles or nerve damage are the most common causes of squint eye. When the muscles around the eye are weaker than other muscles, they are unable to coordinate and work together efficiently. As a result, when one eye is looking at an object, the other eye seems to be looking elsewhere.

In this scenario, the brain receives two different signals from each eye. The brain ignores the message from the weak eye. A squint eye is present at birth but may develop later due to eye injuries and general health conditions.

What are the risk factors that can lead to the development of a squint eye?

The major risk factors vis-à-vis squint eye include:

1. People who have experienced stroke or are affected with Down syndrome or cerebral palsy are more prone to developing a squint eye
2. People with hyperopia or far-sightedness are at a higher risk of developing a squint because of the extra strain they tend to put on their eyes to see clearly
3.  People who have a family history of squint eye are more susceptible to getting afflicted
4. Poor vision in one eye
5. Hydrocephalus (a congenital disease that results in a buildup of fluid in the brain)
6. Brain tumors
7. Head injuries, which can damage the area of the brain responsible for control of eye movement, the nerves that control eye movement, and the eye muscles
8. Neurological (nervous system) problems
9. Graves’ disease (overproduction of thyroid hormone)

How can squint eye be treated or corrected?

Squint eye does not get cured on its own with the passage of time and requires medical intervention.

The prescription of glasses is the initial stage in squint correction. The doctor evaluates the squint after the spectacles have been worn. Based on age, the doctor may recommend patching the healthy eye if the patient has an amblyopia lazy eye. In the case of children, this strategy may result in the improvement of vision in the weaker eye by forcing the brain to receive signals only from the weaker eye. This treatment has been found to be successful for children under the age of 8.

Surgery in one eye may be required in other cases, and in case of major abnormalities, surgery maybe required on both eyes. Most squint procedures produce a perfect cosmetic result.

Although, amblyopia treatment outcomes in adults are not as promising as in children, most patients gain considerably from prescription glasses. If the squint does not get cured even after a long period of time despite treatment, the doctor may suggest a surgery to correct the resultant double vision(diplopia) and deviation.

Squint treatments are done based on four strategies:

1. Glasses and myopia therapy for restoration and correction of vision
2. Correction of deviation for cosmetic purposes
3. Correction of deviation for preservation and restoration of binocular vision
4. Prevention of diplopia

A Note from Apollo Hospitals/Apollo Group

Eye muscle surgery or squint correction surgery helps to improve the vision and alignment of the eyes significantly. Based on the type of squint, two or more operations may be required for a complete cure. You can always reach out to experts at Apollo for more details.

Frequently Asked Questions (FAQs)

• Is squint only a cosmetic problem?

That is not necessarily the case. A squint can also be accompanied by resultant diplopia also known as double vision. The inability to use both eyes can lead to the loss of depth perception and peripheral visual field.

• How many surgeries are required to cure a squint?

A squint usually requires one surgery to correct the alignment issues. However, if the squint is extremely pronounced, your doctor may suggest a two-stage surgery.

• What are the precautions to be taken after a squint eye correction surgery?

Care must be taken to avoid getting shampoo or soap in the eye while washing. It is also advisable to avoid contact sports and swimming for up to a period of four weeks after the surgery. You should also try avoiding use of cosmetics around the eye area for four weeks post-surgery.