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Questions about Squint Surgery

Questions about Squint Surgery

What is squint (strabismus)?
Squint is a misalignment of the two eyes where in two 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 called as intermittent squint.

What causes squint?
The exact cause of squint is not known.
Six muscles control the movement of each eye (see picture) . 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.
Sometimes a refractive error hypermetropia (far sightedness) or an eye muscle paralysis may lead to 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.

How is squint diagnosed?
The squint is diagnosed by the ophthalmologist specializing in that field. He or she would do a few special tests to confirm the presence of squint, and find out the type of the squint. In some cases there may be a false appearance of squint due to broad nasal bridge in a child. This is called as pseudo squint.

What is the aim of the treatment for squint?
The aims of treatment of squint in order of importance are:

  • Preserve or restore vision
  • Straighten the eyes
  • Restore 3D vision

When should the squint be treated?
In a child, the treatment of squint and any associated amblyopia should be started as soon as possible. Generally speaking, the younger the age at which amblyopia is treated; the better is the chance of recovery of vision.
Remember that the child would never grow out of squint. A delay in treatment may decrease the chances of getting a good alignment and the vision.

What is the treatment for squint?
A. Treatment depends on the type of squint and may include spectacles, patching, surgery or any combination of these. What is right for one child is not necessarily right for the next

Are glasses necessary?
If the child has significant refractive error, glasses are 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 alignment of eyes after they have been aligned by surgery. Remember surgery cannot replace the need for glasses.

What is patching therapy?
In some children, squints cause the squinting eye to become ‘lazy’ and stop working properly. Patching the ‘good’ eye will make the lazy eye work harder, which improves vision.
Patching improves vision it does not treat the squint, although the unpatched eye will appear to be straight while the patch is worn. Sometimes when the patch is removed the squint may be temporarily more noticeable but later returns to the pre-patching position.
The patch is made from non-irritating material to prevent rashes, and spectacles are worn over the patch.
It is thought that the patching therapy works best for children below 7-8 years of age.

What are the success rates of a squint surgery?
Nearly 80-90% patients are successfully corrected in the straight-ahead position with one surgery. In some patients the surgery may be only partially successful. In some patients the eye alignment will change over time, resulting in the need for additional surgery after few months or years.

How is the squint surgery performed?
The squint surgery is done under local or general anesthesia depending on the age of the patients and the complexity of squint.
The surgical technique used in our hospital is fornix incision and adjustable technique, which is state of the art.
Feel free to ask any other questions to our Squint specialist