Normally both of our eyes are perfectly aligned and move in tandem with each other in all directions of viewing.
When one or both eyes do not move synchronously , are turned inwards or turned outwards , is called Squint.
Could be congenital , by birth.
Could be refractive , due to a high plus or minus number.
Could be due to paralysis of one or more muscles that move our eyes.
Refractive error ( Spectacle number ).
Visual acuity .
Both of these things are difficult to check and determine in very young children.
In very young children the eyes may appear squinty due to the broad nasal bridge. This squint is not real but only appears to be so. This disappears at the child grows up.
Every child of squint needs to be checked for spectacle number and for vision. This may be difficult to do in very young children and needs a very persistent approach by the eye surgeon by teaming up with the parents to take care of the child.
Glasses if required need to be worn by the child.
Vision stimulation therapy , both active and passive needs to be carried out. Many patients improve with this treatment alone.
This needs to be continued until the doctor feels that delaying any further may severly jeopardise the visual development of the child . Then a decison is taken to treat the squint surgically.
Many squints can be treated quite adequately with surgery. During surgery , the surgeon may weaken or strengthen the muscles that move oue eyeball.
If vision of both eyes is good (with or without glasses) , there is a very good chance of near normal correction.
If vision of one or both eyes is weak , the correction may not be perfect but still a lot of improvement is possible.
More than one surgery may be required for surgical correction of squint.
Glasses if required , must be continued even after squint surgery .
It is much harder to treat squints caused due to paralysis of one or more muscles that move the eyeball or in cases where there is abnormal innervation of the muscles.
In such cases , often our goal in such cases is to correct the abnormal head position associated with this squint.
Surgical correction for squint should preferably be carried out by the time the children start going to school. Delaying it any further may cause harassment at the hand of schoolmates and associated psycological problems.