Squint or Strabismus: Causes, Symptoms, Types, Treatment In Adults and Children.

An Overview of Squint Eye!

Squinting eyes is an eye disorder in which the eyes don’t look at the same direction at the same time. Squint eyes are also known as Strabismus Eyes or Cross-Eyes. Strabismus occurs when there is an incorrect balance of the muscles controlling the movement of the eyes or when faulty nerve signals are sent to the eye muscles, thus weakening the eyes to focus and resulting in squinting. When your eyes are out of balance, your eye may turn in, out, down or up – thus disallowing your eyes to look at things properly in the same direction.

Squint or Strabismus is something one can be born with as well as something that can be acquired due to numerous reasons after birth. Squint can affect humans of any age group.

There are different reasons for the eyes to squint. While sometimes it can be caused when the muscles controlling the movement of the eyes move in the wrong way, it can also result from two muscles trying to control the movement of a single eye. People with Squint or Strabismus have vision problems as decreased amount of light enters one’s eyes.

Parents often find their children developing squint after six months of their birth. In this case, a visit to the optometrist is a must and prescribed guidelines must be adhered to get rid of the squint. Generally, the affected eye tends to have poor vision, especially in children. Vision is not usually affected in case of a long standing squint. It is believed by a lot of people that squinting worsens one’s eyesight, but the worse trouble is it gives a long standing headache as the facial muscles get contracted.

Squint or Strabismus

Is There Any Specific Age Group Which is Most Likely To Have Squint or Strabismus?

Mostly, young children between the ages of two weeks to 5 years are more likely to have squint or strabismus. It can be genetic or it might be acquired due to diseases attained in one’s childhood. Whereas adults have squints too and their causes vary from that of children.

What are the Causes of Squint or Strabismus?

There are different types of squint or strabismus, but the causes of squint are not always known. Children are more likely to have squint than others. People who do not use their glasses or have refractive errors in the eye might suffer from squint.

Let us have a look at the different causes of squint or strabismus:

Hypermetropia

Hypermetropia or long-sightedness can be one of the cases of squint or strabismus, because in hypermetropia, the eyes tend to over-focus in order to have a clearer view. But, in an attempt of avoiding double vision, it might so happen that the brain might not utilize one eye in viewing a particular image, altogether. If hypermetropia is not treated well, there is a high chance of the patient having ‘lazy eye.’ This kind of squint is mostly observed in children of 10 months to 2 years, but this can happen to any children till they attain 5 years of age. The symptoms are usually observed when the children are concentrating on something very close to their eyes like reading, solving puzzles or when babies keep looking at their toys for a long time for a long period of time.

Nerve Damage

Complications during pregnancy or during the child’s birth can cause nerve damages, which can cause squint or strabismus in infants after birth.

Childhood Illness

Diseases like chickenpox or measles might also be the reason for developing squint in children (strabismus). This means that there was a tendency in the child to squint but because of the disease, the child might have been able to keep the eyes straight. But after some period of time, the child might squint because of the tendencies he/ she might have possessed.

Congenital Squint or Strabismus

There have been many cases where the child is born with a squint or strabismus, which may not be obvious for weeks. But in almost half of these cases, there is a family history with the need of glasses or history of squint. In this case, the eye muscles are mostly at fault and usually the primary cause of squint or strabismus. If the baby is suspected as having a squint, he or she must be referred for accurate assessments as soon as possible. Cases of pseudo-squint have been found where the baby is suspected to have a squint, but then diagnosis has revealed reasons pertaining to the shape of the head.

Prematurity

Children who are born before 32 months of pregnancy are at higher risk of having a squint or strabismus.

Eye Conditions

Abnormalities like cataract can also cause poor vision, which results in damage to the retina to such a great extent that the affected eye develops a squint or strabismus.

Myopia

Short sightedness can be the reason for someone to develop squint. In this type of abnormality, the objects close to the eyes are clear and distinct, but the one’s which are distant seem to be blurry and out of focus resulting in a squint.

Other Causes of Squint or Strabismus

Children with Down’s syndrome and cerebral palsy are more prone to develop squint.

What are the Symptoms of Squint or Strabismus Eyes?

Every disorder has its symptoms and the most common symptom of squint or strabismus is that the two eyes look at two different directions at the same time. But the actual symptoms of squint can be very difficult to detect, mostly in children. Children can also complain regarding double vision or other eye problems. If a child is suspected as having squint or strabismus, your health advisor or GP must be asked for a referral to an optometrist for assessment, as soon as possible. While squint is usually self-diagnosable; blurred vision and double vision accompanied with headache which are the symptoms of squint or strabismus can be treated.

What are the Types of Squint or Strabismus?

There are numerous types of squint. While the peripheral symptoms remain the same in most, their causes and consequences differ a great deal. The different types of squint can be described depending on the following points:

Constant Squint & Intermittent Squint: When the abnormality can be seen all the time, then it is known as constant squint type. But if the squint isn’t permanent, but keeps recurring, then this type of squint is known as intermittent.

Congenital Squint & Acquired Squint: If one is born with the squint, then this type is commonly known as infantile. But if it’s acquired later after six months of their birth, it’s called acquired squint.

Refractive Squint & Non-Refractive Squint: Squint caused by refractive error is called refractive squint type and the ones without the mentioned error is non-refractive squint type.

Convergent Squint & Divergent Squint: If the affected eye turns inwards, then it is called a convergent squint or esotropia. If the eye turns outwards, then the type is called a divergent squint or exotropia, and when the eye turns upwards, the type is called hypertropia and if the eye turns downwards, it is called a hypotropia.

Incomitant Squint & Concomitant Squint: Squints can also be categorised with the involvement of certain muscles. If the squint changes with relation to direction, it is called an incomitant squint and if the squint remains the same while looking in all the directions, it is known as concomitant squint.

How Can Squint or Strabismus be Detected?

Squint or Strabismus can be usually noticed by family members, friends and detected precisely by healthcare professionals. The government recommends your child’s vision to be examined before their 4th or 5th birthday. That is the time when kids generally start going to schools. This screening is necessary to ensure that your child is not experiencing any difficulties regarding vision or developing any other deformity that might pose as hazardous in the future. This process is generally carried out by professional orthoptists to make sure every child has good vision and if someone is found with any kind of defects in the vision, they are provided with the necessary clinical care. But unfortunately, there have been regions that are deprived of such clinical help and procedures in the country. So, it might be necessary for parents to take their wards to eye-clinics for eye check-ups from time to time. If you have suspected squint in your child, take an appointment from an orthoptist and visit them to get the necessary care your child deserves.

If a squint goes undetected before the child attains 7 years of age, there is a high possibility that it can damage the vision of your child permanently. Thus, it is important to take precautionary measure before it is too late. It is pertinent to visit eye-clinics for detecting squint on time along with other eye defects to get proper treatment on time to prevent any severe damage to their eye sight.

What is the Treatment of Squint or Strabismus in Adults?

Squint or Strabismus is a condition where the eyeballs are not aligned properly. The eyeballs tend to point towards different directions. However, there are certain treatments for squints in adults. Let us take a look at the treatment options:

Eye Exercises

You can treat squints by exercising your eye muscles. If an adult is suffering from squints, you are incapable of close work or reading. This condition is also called convergence insufficiency. Though eye muscle exercises aren’t entirely effective, there’s no harm in trying out some.

Read about Exercises for Eye

Prism Eye Glasses

You can use prism eye glasses to treat squints or strabismus in adults. A prism is a wedge shaped lens that refracts rays of light. Anyone who has mild double vision can use these glasses and realign the images together so that you can see only a single image. However, if the condition is severe, the chances of effectiveness reduce.

Eye Surgery

Eye surgery is the most recommended option for treating squints or strabismus in adults. Surgeons can surgically tighten or loosen eye muscles so that the eye works properly. It also helps to reduce eye fatigue and helps to expand your side vision. While the thought of an eye surgery might worry you, this is the most assured way to get rid of squints and get proper vision.

Adjustable stitches surgery is also an option you can consider. This procedure allows your eye alignment to be adjusted after you’ve experienced the surgery. This kind of surgery can be performed in two stages. Stage one includes ‘bow tie stitch.’ In the second stage, sutures are untied and tied again to adjust with the realignment. One of the most recommended options, this procedure has allowed many to cure their eye squint.

Treatment of Squint or Strabismus in Children

Many children tend to suffer from squint or strabismus. At times, it can also weaken their vision and eye sight. Though squints can occur due to numerous reasons, it is important to cure or treat them. Here’s a look at some of the prescribed treatment options for treating squint in children:

Glasses for Treating Squint or Strabismus in Children

Glasses often tend to cure squints in children. The child might need to wear glasses all the time.

Occlusion Therapy

Occlusion therapy is an effective option to treat squint or strabismus in children. Here the eye, which is not affected, is often covered with a patch. Then your child has to use the other eye to see things around. This allows the deflected eye to focus better and improves the relationship between the eye and the brain.

Eye Exercises for Treating Squint or Strabismus in Children

Ask your child to exercise his or her eye muscles more. There are several easy exercises, which your child can perform at home. This kind of treatment is preferred in case of children, as it is less invasive.

Read about Yoga for Eyes

Eye Surgery

You might also want your child to get eye surgery. It is usually a day procedure and so your child will be discharged as soon as possible. In order to improve alignment, the eye muscles need to be strengthened through surgery. It helps to develop the visual pathway of the lazy eye. Surgery can also help to make eyes appear normal and straight and get rid of squint or strabismus in children.

Botox for Treating Squint or Strabismus in Children

Botulinum toxin injection can be used as a temporary cure for squint in children. This treatment is generally carried out under anaesthesia in case of children. This weakens the muscles that pull the eyes towards each other. However, this cannot be prescribed for all types of squint or strabismus. The effect of this may or may not be temporary, but for some types of squint, it has turned out to be very effective.

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