Strabismus (squint) is a condition in which eyes are misaligned and point in different directions. One eye may look straight ahead while the other turns inward, outward, upward or downward.

You may always notice the misalignment or it may come and go. The turned eye may straighten at times and straight eye might turn.

Squint is not a sign of luck. It is a disorder.

In normal vision both eyes focus at the same spot. The brain then fuses images in both the eyes into a single three dimensional image. This 3_D image gives us depth perception.

The eyes of many young children seem crossed. Children have a flat nose and a fold of skin at the inner eyelid and this can make the eyelid crossed.

This appearance of strabismus can disappear after sometime. A child will not outgrow true strabismus.

An ophthalmologist can usually tell the difference between a case of genuine strabismus and one that appears like it.

Good vision develops during childhood when both eyes have normal alignment.
Strabismus may cause reduced vision or amblyopia, in the weaker eye.

The brain will recognize the image of the better seeing eye and ignore the image of the weaker or the amblyopic eye. This occurs in approximately half the children who have strabismus.

Amblyopia can be treated by patching the good eye to strengthen and improve vision in the weaker eye. If amblyopia is detected in the first few years of life, treatment is usually successful.

If the treatment is delayed until later, ie under 12 years, amblyopia usually becomes permanent. As a rule, the earlier amblyopia is treated, the better the visual result.

Strabismus is a common condition among children.
It occurs equally in males and females.

Strabismus may run in families. However, many people with strabismus may have no relatives with this problem.

The exact cause of strabismus is not fully understood.
There are six eye muscles controlling eye movement attached to the outside of each eye. In each eye two muscles move the eye right or left and the other four up/down or at an angle.

To line up and focus the eye on a single target, all of the muscles in each eye must be balanced and working together. In order that both eyes must move together, the muscle movement in both eyes must be co ordinated. The control of these muscles happens in the brain.

A cataract or an eye injury that affects vision can also cause strabismus.

The main symptom is that one eye is not straight. Some children will squint in bright sunlight and tilt their head to use their eyes together.

Strabismus can be diagnosed during a physical exam by an ophthalmologist. It is advised that all children have an eye exam at four years or even earlier. If there is a family history of amblyopia or strabismus an ophthalmologist can check vision even before three years of age.

Strabismus treatment aims to:
Preserve vision
Straighten Eyes
Restore binocular vision

In some cases eyeglasses may be prescribed
In others, surgery is the option involving either removal of cataract or correction of unbalanced muscles.
Patching the strong eye and exercising the weaker eye is also a part of strabismus treatment.

Surgery may be required in one or both eyes.
Strabismus surgery is performed under general anaesthesia in children; in adults it can be performed under local anaesthesia.

In some cases eyeglasses may be prescribed
In others, surgery is the option involving either removal of cataract or correction of unbalanced muscles.
Patching the strong eye and exercising the weaker eye is also a part of strabismus treatment.

A small incision on the tissue covering the eye is made.
(The eye is not removed from its socket)
Muscles are repositioned during the surgery.

For children it is advisable to opt the surgery before they start schooling.

As with any surgery, eye muscle surgery has some risks. These include infection, bleeding, excessive scarring and other rare complications that can lead to loss of vision.

But generally, it is considered a safe surgery. Recovery after surgery is fast. Usually people resume routine activities in a few days. After surgery glasses or prisms may be required. Strabismus surgery is a safe option for mis aligned eyes. But it is not a substitute for glasses or amblyopia therapy.

Source: This material has been sourced from Rajan Eye Care, Chennai.