Pediatrics and Squint
Pediatric ophthalmology is concerned with ocular conditions and vision care in infants, children, and adolescents. Strabismus is misalignment of the eyes. Including esotropia, exotropia, orhyper/hypotropia, strabismus is a condition that must be corrected. Amblyopia, or lazy eye, is the most common cause of visual impairment in childhood. It may be caused by strabismus as well as by deprivation or refractive error. It is most commonly treated with occlusion therapy, achieved through either patching or eye drops. Other, more rare pediatric conditions include congenital ocular abnormalities, retinal disorders, juvenile cataracts, and juvenile glaucoma. Screening in children beginning in infancy is of the utmost importance, because early diagnosis offers the best chance for effective treatment of pediatric eye conditions.
What is squint (strabismus)?
Squint is a misalignment of the two eyes so that both the eyes are not looking in the same direction. This misalignment may be constant, being present throughout the day, or it may appear sometimes and the rest of the time the eyes may be straight.
Vision through Squinted Eyes
It is a common condition among children. It may also occur in adults.
What causes squint?
The exact cause of squint is not really known. The movement of each eye is controlled by six muscles. Each of these muscle acts along with its counterpart in the other eye to keep both the eyes aligned properly. A loss of coordination between the muscles of the two eyes leads to misalignment. This misalignment may be the same in all directions of gaze, or in some conditions the misalignment may be more in one direction of gaze, e.g., in squint due to nerve palsy.
Sometimes a refractive error hypermetropia (long sight) may lead to inward deviation of the eye. Poor vision in an eye because of some other eye disease like cataract, etc. may also cause the eye to deviate. Therefore it is important in all the cases of squint, especially in children, to have a thorough eye checkup to rule out any other cause of loss of vision.
What is the treatment for squint?
The aims of treatment of squint in order of importance are:
First of all, the eyes are checked to see if they have any refractive error that may be responsible for squint. If there is any significant refractive error present, it is treated first. In some cases (accommodative squint) a correction of refractive error is all that may be required to treat squint.
Next the eyes are checked for presence of amblyopia. It is important to treat the amblyopia before the surgery for squint. The parents are explained about the importance of this treatment, as their cooperation is very crucial for the success of this treatment.
- Preserve or restore vision
- Straighten the eyes
- Restore binocular vision
The squint is treated by surgery of either one or both the eyes. The surgery involves weakening or strengthening of the relevant muscles to restore the balance and to get a good coordination. In some cases with double vision, prisms may be added in the glasses to ease the symptoms.
Are glasses a must?
Surgery can not replace the need for glasses. If the child has significant refractive error, glasses are a must. In some cases wearing glasses may correct squint. In other cases, wearing glasses help the eyes to see clearly. This clear vision is very important for the treatment of amblyopia, and also for maintaining the coordination of eyes, once they have been aligned by surgery.
- Microsurgical Squint corrections