The strabismus, a condition that is also commonly known as squint eyes is the loss of parallelism of the ocular axes producing, on one hand, ocular deviation, but also a sensory alteration of the vision.
Is There A Cure For Squint Eyes?
Faced with a squint eye problem, doctors must consider, at first, the fight against amblyopia and the treatment of the refractive defect, in order to improve either visual acuity or correct the accommodative component of that deviation. Once the glasses are prescribed, it can occur that:
– The visual acuity is normalized, which means that there is no amblyopia.
– The visual acuity does not improve, which confirms that the patient has an amblyopia against which doctors must fight as early as possible.
The Guidelines To Follow To Treat Amblyopia Are:
- Occlusion preferably with patches adhered to the skin. The type of occlusion can be hourly or daily, depending on the magnitude of the amblyopia and the patient´s age. In children under one year, full-day occlusions should not be performed because amblyopia can be created in the healthy eye.
- Optical penalty: Overcorrecting the refraction of the healthy eye in those cases in which the vision of the amblyopic eye has surpassed 0.5 of visual acuity, and when putting the penalty creates an alternation in the dominance of far-near vision.
- Pharmacological penalty, with mydriaticeye drops in the healthy eye. Regarding the correction of the accommodative component of squint eyes with glasses, it can occur:
- That the deviation is completely corrected: so doctors would be before a pure accommodative squint eyes that is treated only with glasses.
- The deviation is corrected partly with glasses, leaving a residual angle: accommodative squint eyes mixed that will be treated with glasses and with surgery.
- The deviation does not vary with the use of refraction and its treatment will only be surgical.
It consists of reinforcements or weakening muscles according to the type of affectation. The weakening consists of myotomies or myectomies, and the reinforcements, in resections or muscular folds. These surgical techniques are quantified in millimeters, which are directly related to the degrees of deviation measured with the prism bars. Patients do not always improve with a single intervention, but two or more surgical acts are required for complete correction.
Another technique that has been used for the treatment of squint eyes is the injection of botox (botulinum toxin) on the hyperfunctioning muscle causing a paresis in it.
This type of treatment can have results moderately good in the squint eyes of the infant, but it is often necessary to repeat the doses and it does not always get completely corrected, needing to complete the correction with surgery over time. The application of botox is more effective in the early treatment of paralytic squint eyes, should be injected into the healthy muscle. The advantages of this treatment lie in the type of anesthesia, which is smoother, and the surgical time, which is more reduced.
The squint eyes surgery corrects the aesthetic component, but not the amblyopia nor the refractive defect. Thus, once the patient has been operated on, if amblyopia persists, the rehabilitation treatment must be followed, either with patches or with a penalty.
The refractive component should also continue to be treated after the intervention. The success of these treatments depends on the start of them. The sooner the refractive problem and amblyopia are diagnosed and treated, the recovery will be better. The surgical moment depends on each case and does not always have to be early.
It is necessary to emphasize the preventive work of the pediatrician, controlling the visual acuity in the children and doing the cover test as well as stereoscopic vision tests and if the presence of an amblyopia or a squint eye is suspected, request an ophthalmological review as early as possible.
As it was aforementioned, “squint eyes” or strabismus is a medical condition that has a better prognosis if it is diagnosed and treated at an early age. Fortunately, there are several treatments available for the patients. If conventional therapies do not work out, a surgical intervention may be required.
- American Academy of Ophthalmology. (2019). Treatment of Strabismus. https://www.aao.org/eye-health/diseases/strabismus-treatment
- Chua, B., & Kifley, A. (2005). Squint surgery for adults: A patient’s guide. Clinical and Experimental Optometry, 88(6), 371-378. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1444-0938.2005.tb06717.x
- American Academy of Ophthalmology. (2021). How to Treat Strabismus (Misaligned Eyes). https://www.aao.org/eye-health/diseases/strabismus-treatment