Squints In Children or Strabismus

Squint Clinic

Eye Solutions is proud to have a specialized department dealing with both children and adults with squints.  The presence of one of the best squint specialists in Mumbai, infrastructure catered to dealing with children, and years of experience make us one of the best hospitals for treating squints.

What are squint / Cross eyes ?

A squint is when the eyes are not aligned.  This is what happens normally, We see one object with both eyes open and both eyes are looking at that object.  Now here is something interesting. Each eye forms an image of the object that we are looking at and sends that image to the brain.  Thus the brain receives two images. The brain fuses both these images together and we see one object. The interesting part is all of us take this phenomenon for granted.  When actually it is just amazing that we have this ability. This act of fusing these two images is called fusion. This fusion gives us what we call binocular vision. Binocular vision is something that gives us depth perception.  We as humans have depth perception, For sake of understanding eagles too have depth perception. They can fly down from the sky, pick up a mouse walking on the ground, and fly back up. They don’t crash into the ground and that is because they know exactly where the ground is in the 3D space.  We as humans to have depth perception.

When there is a squint the eyes are not aligned.  One eye is looking at the object and one eye is looking elsewhere.  There are various causes of squint. But whatever the cause the misalignment can cause some additional problems to the patients.

What are the causes of squints ?

There are various causes of squints.  Some are more obvious and some are theories that have been put forward by the founding fathers and others of this specialty.  Here are some of the causes:

• Congenital squint – These squints are present since birth.  Though the eye structure and vision are completely normal there was some deficiency in development leading to the squint.
  Acquired squint – These squints occur later in life.  They could be due to the wrong position of eye muscles, differing strengths of eye muscles, not a completely normal shape of the bony orbit.
• Squints due to poor vision – When one eye has poor vision then that eye tends to drift outwards because there is no stimulus to hold the eye in alignment
• Trauma – Injury can cause injury to the muscle or nerve or even the bony orbit around the muscle and this can lead to a squint
• Nerve Palsy – This is something like a stroke except that the eye muscles are affected and nothing else.  Of course one may get eye nerve palsies along with other paralytic issues too. This may happen because of space-occupying lesions in the brain or even problems like high blood sugar or high blood pressure
• Congenital malformations – Here there could be some defect during the development of the orbit or of the nerves of the eyes and these can cause squints
• High-powered numbered glasses – If a child has a high number and does not wear glasses it could lead to squinting.
• Diseases like hyper or hypothyroidism can cause squints.
• Not so commonly genetics plays an important part.
• There are a few more but those could be avoided for this text.

What are the symptoms of strabismus ?

When a person has a squint or strabismus they may face certain issues.  As mentioned earlier both our eyes see one object, send two images to the brain and we see it as one because of what is called fusion.  

What are Suppression and Diplopia ?

When someone has a squint, one eye is seeing one object but the other eye is seeing another object.  The brain can deal with this situation in two ways. Which of the two happens depends on the age of the individual with the squint.  If a child has a squint then we get a phenomenon called suppression. The brain ignores the image that is coming from the eye which has deviated.   Here the person sees a single image but the person does not have a binocular vision or depth perception.

Sometimes however squints may occur in adults and the phenomenon of suppression is not possible in adults.  Actually, suppression happens in children because there is some plasticity in the brain and its functions. In adults, this plasticity does not exist.  So when an adult develops a squint she will see double. Also known as diplopia. So diplopia is one symptom of adult squints.  

The most common symptom is of course not like the cosmetic appearance of the squint.  Both younger and older individuals want to get this squint corrected for just this one reason.  

• Patients may complain of eye pain or eye strain because of squints
• Glare when they step outside into the sun
• Not seeing clearing in one direction of their visual field
• Seeing double in only one direction of their visual field

How to avoid squint ?

Surprisingly, how can we avoid squints is a frequently asked question.  We say surprisingly because when the squint occurs naturally there is nothing that we have done wrong for them to occur.   So no one cannot do anything to avoid squints. But if we remain healthy by controlling our blood sugar and blood pressure and treating our thyroid eye disease then yes you would end up avoiding squints caused by these factors.

That being said in the recent past we have been seeing certain squints due to excessive smartphone usage.  This we are seeing in both adults and children and here is again one thing that we should avoid. But that we already know.

Is there any squint treatment at home ?

Most, not all squints are treated by surgery and unfortunately, there is no treatment at home for this squint.  Some squints which are not treated by surgery are treated by prescribing certain glasses and fewer are treated by exercises.   So the answer is no one cannot do much at home for the treatment of squint. However, as mentioned earlier excessive smartphone usage can cause some types of squint and should be avoided.

Also read: Squint Consultation| Squint Surgery