Squint

Children Need Extra Care

Eyes of children are different from adults and require specialized treatment. At Eye7 we have dedicated team of Pediatric Ophthalmologists specially trained to take care of the little ones.

Squint, also known as crossed eye or strabismus, is the medical term used when the two eyes are not looking straight. It occurs in children in 2 to 4 percent of the population. A suppression of vision may occur in the Squinting eye which becomes permanent if treatment is not initiated on time.

Strabismus

Strabismus, also known as crossed or turned eye, is the medical term used when the two eyes are not straight. It occurs in approximately 2 to 4 percent of the population.

What Are the Different Types of Squint ?

There are three common types of squint:

Crossed eyes

A child may be born with this condition, or it may develop within a few months of birth or around two years of age. This is also called esotropia, or convergent squint.

Divergent Eyes

A child may be born with this condition, or it may develop later. This is also called exotropia, or divergent squint.

Vertical Squint

The eyes are out of alignment vertically.

Symptoms

  • Turned or crossed eye
  • Squinting
  • Head tilting or turning
  • Double vision (in some cases)

Diagnosis

It is possible to examine a child of any age for squint and determine whether the eyes are properly focused. If you are not sure whether your child’s eyes are straight, consult your family doctor, who may advise referring the child to an ophthalmologist.

The ophthalmologist may use special tests, such as prism testing, to evaluate the alignment of the eyes.

Risk Factors

Most commonly, a tendency to have some type of squint is inherited. If any members of your family have had squint, the condition is more likely to develop in your child.

Sometimes the condition is due to the eyes being far-sighted and the need for corrective eyeglasses or, occasionally, to some muscle abnormality. Very rarely, squint may be secondary to a serious abnormality inside the eye, such as a cataract or tumour.

What You Can Do to Reduce Risk?

Any cause for poor vision in one eye in a child may lead to squint. There are many causes for poor vision in one eye, but a major concern of ophthalmologists is retinoblastoma, a malignant tumor of the retina. Although it is very rare, in the range of one in 20,000 children, this possibility is why every child with squint should have a pupil dilated examination of the retina as soon as squint is recognized.”

To detect poor vision in one eye or the other, parents should take children for regular eye examinations according to the following timetable:

  • Newborn to 3 months
  • 6 months to 1 year
  • 3 years (approximately)
  • 5 years (approximately)

However, if you or your child notices problems with his or her vision, visit the eye doctor immediately.

What happens to sight in eyes with Squint?

Defective binocular vision
The eyes need to be straight for fusion in the brain of the images of the two eyes. This gives accurate vision and stereopsis, or 3-D vision; 3-D vision is used to judge depth.
Reduction of vision in the turned eye (amblyopia)
A reduction of vision may occur in one eye in squint, especially under certain circumstances, such as late treatment.

One such circumstance is if a child is born with straight eyes, but one eye turns in around age two. If this condition is not treated urgently, vision may be reduced to partial sight (legal blindness) in the turned eye. If treatment is begun immediately, however, perfect vision can often be restored.

Treatment

The aim of treatment is to restore good vision to each eye and good binocular vision. Treatment usually includes patching the eye that is always straight to bring the vision up to normal in the turned eye. Glasses may be used, particularly for eyes that are out of focus. Glasses and special drops (phospholine iodide) may also help straighten the eyes. Surgery on the eye muscles is sometimes necessary.

Why is an operation necessary?

Sometimes it is the only way of straightening the eye sufficiently for sight to be restored in the squinting eye. If performed at the appropriate time, results can be very good and satisfactory and Three Dimensional vision can be developed. However, when the results are only cosmetic, they improve the child’s appearance only. It is sometimes possible to do more than one operation to achieve the desired results.

How is the operation done?

It involves repositioning the relevant eye muscles on the eye ball. This could mean either shortening or loosening of muscles with surgery.

What happens after operation?

Squint surgery is a day care procedure where the patient is sent home on the day of surgery itself. The eye may appear red after surgery, but this settles down in a few weeks. One should be able to return to school after about 10 days of surgery. If the child wears the spectacles before the operation, spectacle will still be needed after the surgery.

Ambylopia / Lazy Eye

What Is Amblyopia?

Amblyopia, also known as “lazy eye,” is reduced vision – uncorrectable with lenses – in an eye that has not received adequate use during early childhood. There is no visible anatomical defect. Amblyopia has many causes. Most often it results from either a misalignment of a child’s eyes, such as crossed eyes (strabismus), or a difference in image quality between the two eyes (one eye focusing better than the other, also known as anisometropia). In both cases, one eye becomes stronger, suppressing the image of the other eye. If this condition is not treated in early childhood, the weaker eye may become permanently impaired. With early diagnosis, amplyopia can be treated and loss of vision prevented.

What Are the Different Types of Amblyopia?

Strabismic amblyopia and anisometropic amblyopia are the two most common types. In strabismic amblyopia, the child has strabismus and the eyes are not aligned correctly so that one eye sees a different image from the other. In the eye that is deviated, the images seen by brain are suppressed to avoid double vision.

With anisometropic amblyopia, the eyes possess differing refractive powers. For example, one eye may be near-sighted while the other is far-sighted or strongly astigmatic. As a result, the brain will favour the eye with the clearer image and begin to ignore signals from the other one.

What Causes Amblyopia to Develop?

Amblyopia develops when any of the following conditions occur in an infant or young child:

  • “Squint” / strabismus (eyes not positioned straight)
  • Congenital cataract (clouding of the lens in an infant)
  • Uncorrected high near-sightedness (myopia) or far-sightedness (hyperopia) in both eyes
  • Uncorrected high myopia or hyperopia in one eye (one eye focuses differently from the other)
  • Severe ptosis (droopy eyelids)

Why Does Amblyopia Develop?

Amblyopia develops because when one eye is turned, as in squint, two different pictures are sent to the brain. In a young child, the brain learns to ignore the image of the deviated eye and see only the image of the better eye.

Similarly when there is difference in refractive power between the two eyes, the blurred image formed by the eye with greater uncorrected power is avoided by the brain. A moderate or high degree of refractive power present in both eyes, when not corrected early and adequately, results in amblyopia.

In order that the retina may register an object, it needs adequate light and visual stimulus. When these factors are absent, as in the presence of cataract in an infant, amblyopia also results.

Symptoms

  • Eye turning in, out or up
  • Closing one eye (particularly in bright sunlight)
  • Squint
  • Headaches or eyestrain

Risk Factors

Children under nine years of age whose vision is still developing are at highest risk for amblyopia. Generally, the younger the child, the greater the success of treatment. An older child may not achieve normal vision with treatment.

What You Can Do to Reduce Risk

Since amblyopia is caused by many conditions, such as strabismus, near-sightedness (myopia) or far-sightedness (hyperopia), the diagnosis and successful treatment of these vision conditions should reduce the risk of amblyopia.

Treatment

Amblyopia can often be reversed, or at least reduced, if it is detected and treated early. Cooperation of the patient and parents is required to achieve good results. If left untreated or if not treated properly, the reduced vision of amblyopia becomes permanent and vision cannot be improved by any means.

The most effective way of treating amblyopia is to encourage the child to use the amblyopic eye. Covering or patching the good eye to force use of the amblyopic eye may be necessary to ensure equal and normal vision. This can be achieved by:

  • Prescribing proper spectacles if the patient is found to have refractive error or accommodative esotropia.
  • Prescription of drops such as Phospholine Iodide to reduce the accommodative effort that causes accommodative esotropia.
  • Removal of cataract when indicated.
  • Occluding the normal eye, for example, with a patch.
  • Surgery, when amblyopia is accompanied by strabismus and is unresponsive to conservative treatment.

When occlusion is decided upon, the treatment may vary from a few hours to months or even years depending upon the age of patient, the type and severity of amblyopia, and the response. In cases experiencing less severe amblyopia, partial occlusion, such as that by making one glass frosted, may be sufficient. Older children can do reading exercises at home while patching the normal eye. Those patients who are patching their eyes need periodic follow-up, which is scheduled with an optometrist or ophthalmologist.

Facts on Patching

  • Patching is not a pleasant thing for a child, so initially the child will be reluctant to undergo it. It is our duty to encourage the child to understand the importance of cooperation.
  • In a young child, patching is done for shorter periods initially; the duration is increased gradually to obtain better compliance.
  • Acceptance is good as soon as vision is increased in the ambloypic eye.

Method of patching should be according to the circumstances of the child:

  • Patch should be placed directly on the face over the eye.
  • If the child wears glasses, the patch should be placed over the eye, not on the glasses.
  • Glasses can also be used as an occluder in older children.
  • Many children try to take the patch off. This problem usually disappears as the child grows accustomed to wearing the patch.
  • Precautions must be taken to prevent the child from peeking around the edge of the patch.
  • Patching schedules should be followed strictly.
  • Patching should not be stopped abruptly. The program should be tapered only by ophthalmologists or optometrists.
  • Regular follow-up visits are a must.

COMPUTER VISION SYNDROME

Do you get headaches or eyestrain from staring at your computer monitor? At the end of a long day in front of your computer screen, is it difficult to focus on distant objects? You may be suffering from computer vision syndrome (CVS).

What Are the Symptoms of Computer Vision Syndrome?

If you spend more than two hours per day in front of a computer screen, it’s likely you will experience some degree of computer vision syndrome. Symptoms of CVS include

  • Headache
  • Losss of focus
  • Burning eyes
  • Tired eyes
  • Double vision
  • Blurred vision
  • Neck and shoulder pain

What Causes Computer Vision Syndrome?

Computer eye strain and computer vision syndrome are caused by our eyes and brain reacting differently to characters on a computer screen than they do to printed characters. Our eyes have little problem focusing on printed material that has dense black characters with well-defined edges. But characters on a computer screen don’t have the same degree of contrast and definition.

Words on a computer screen are created by combinations of tiny points of light (pixels), which are brightest at the center and diminish in intensity toward their edges. This makes it more difficult for our eyes to maintain focus on these images. Instead, our eyes want to drift to a reduced level of focusing called the “resting point of accommodation” or RPA.

Our eyes involuntarily move to the RPA and then strain to regain focus on the screen. This continuous flexing of the eyes’ focusing muscles creates the fatigue and eye strain that commonly occur during and after computer use.

Will Glare Screens Prevent CVS?

Anti-glare filters for computer screens may increase comfort somewhat, but they will not solve all your computer vision problems. These filters only reduce glare from reflections on the computer screen and do not reduce the visual problems related to the constant refocusing of your eyes when you work at a computer.

What can I do to avoid getting CVS?

Blink: People blink at least half as much as normal when staring at the computer screen, because people usually squint and your eyes are not made for looking at monitors. It may be hard to remember to do this constantly, so every now and then you can close your eyes for a few seconds.

20-20-20: Every 20 minutes, look at an object 20 feet away for 20 seconds to get them adjusted to long-distance too, so you are ready when you get off the computer.

Adjust the screen settings: You will find that if you make your screen a bit more dull, it is actually easier to read. The screen should be just as bright as your surroundings, and should not appear to be a glowing box nor pitch black object. You will find that you can actually get used to a brightness of 0. Contrast should usually be in the level of the 80s, but they are different for different screens. Contrast is the strength of the colors compared next to each other.

Back up the screen: but not so much that you have to strain to read the text. 16-24 inches is a good distance, depending on your eyesight and the size of the screen. Consider changing the settings to show larger text on every site accessed on your browser. 5. Adjust the height of your desk or chair so the middle of the computer screen is about 20 degrees below eye level. The screen itself should be 16- 30 inches from your eyes.

Adjust the height of your desk or chair so the middle of the computer screen is about 20 degrees below eye level. The screen itself should be 16- 30 inches from your eyes.

Tips

  • Ignore the myth about looking at computer screens making you nearsighted because of the pixels. Looking at computer screens is just like reading a book.
  • Before and after long periods of time with computer use, lubricate your eyes with non-preserved or sensitive eyes artificial tears or take a steamy shower but don’t get regular water in your eyes as this dilutes and flushes out your natural tears.
  • Some of this information can also apply to other types of screens, such as that of TVs, handheld games and cell phones.
  • Stay hydrated so you are sure to have enough tears to make.

Faqs

What is squint?

Squint is a misalignment of the two eyes. The two eyes appear to not be looking in the same direction. This misalignment may be constant, being present throughout the day, or it may appear sometimes What to do if I think my child has a squint? Get your child’s eyes checked by your Eye Specialists. Sometimes eyeglasses may help cure the disease.

What is the symptoms for squint?

In a child, the parents may notice the deviation of eyes. However, please note that the eyes of a newborn are rarely aligned at birth, and gain alignment at 3-4 weeks of age. Therefore squint in any child who is more than one month old must be taken seriously and should be evaluated by an ophthalmologist immediately. Adults may notice double vision, or misalignment of the eyes.

What is the treatment for squint?

Treatment depends on the type of squint and may include spectacles, patching, eyedrops, surgery or any combination of these. Your eye doctor will decide on the best treatment course for you after a series of tests

Squint

Eyes of children are different from adults and require specialized treatment. At Eye7 we have dedicated team of Pediatric Ophthalmologists specially trained to take care of the little ones. Squint, also known as crossed eye or strabismus, is the medical term used when the two eyes are not looking straight. It occurs in children in 2 to 4 percent of the population. A suppression of vision may occur in the Squinting eye which becomes permanent if treatment is not initiated on time. Eye7 has a team of best ophthalmologists in Delhi and they make sure that you are in safe hands.

Doctors

Dr. Manish Sharma

Cataract - Squint

Dr. Manish Sharma is a Squint and Paediatric specialist. He is available at Eye7 Hospitals, Janakpuri.

    Dr. B.S. Goel

    Squint

    Dr B S Goel has done his MBBS from Medical College Patiala (1962), MS in Ophthalmology...

      Dr. Gaurav Kakkar

      Cataract - Squint - Computer Vision

      Dr Gaurav Kakkar has done his MBBS from Kasturba Medical College, Mangalore...

        Dr. Amit Gupta

        LASIK / Specs Removal - Squint

        Dr Amit Gupta is a senior squint specialist at Eye7 Chaudhary Eye Centre, Daryaganj, New Delhi.


          Call Now

          Book Appointment