Squint (Strabismus): Understanding and Treating Eye Misalignment

Strabismus is the abnormal deviation of the eyes, with a loss of parallelism. The result is that each eye points in a different direction (one looking at the object and the other in a different direction).

It is a relatively frequent condition in childhood, affecting 4% of children. It must be detected and corrected early to avoid future vision problems.

Causes

The most common causes of strabismus are: the imbalance of the muscles that control eye movements and some refractive disturbances, such as hyperopia.

Other causes are: eye diseases (of the optic nerve, retina or lens), systemic diseases that may affect the eyes (thyroid disorders, myasthenia gravis, strokes or) or trauma that has damaged the skull or orbit .

An important factor is family inheritance, transmitting the predisposition to suffer this alteration.

The types of strabismus are:

• Convergent strabismus - eyes drift inward
• Divergent strabismus - eyes drift outward
• Vertical strabismus: eyes deviate vertically

Symptoms

Some cases of strabismus are very striking and cause a significant cosmetic defect, others, on the other hand, may go unnoticed due to the fact that the abnormal deviation of the eye is small.

Strabismus may be evident from birth or appear at 3 or 4 years of age, due, for example, to increased hyperopia.

Up to six months of age, children show immaturity in the conjunction of the gaze and eye movements, which is why a certain degree of strabismus may be normal. If after six months the baby continues to deviate his eyes, he should be visited by an ophthalmologist.

Strabismus must be diagnosed early to avoid consequences for the future vision of the child.

Strabismus in childhood does not produce double vision. During the first years of life, the child's brain suppresses the image of one of the eyes at the moment of deviation.

That is why when there is a constant strabismus in one of the eyes, the suppression of the image occurs and causes an eye with amblyopia in a secondary way. A child with strabismus focuses one eye on an object while the other does not follow coordinately.

Treatment

Strabismus does not cure itself, it must always be treated early. After 7 years the possibilities of correction are slower and less effective. It is a long treatment and parents have to be constant.

The treatment of strabismus is aimed at:

• Avoid loss of vision in the deviated eye (amblyopia or lazy eye): for this the child must wear glasses with the appropriate prescription and occlude the healthy eye with a patch so that the other can develop better vision.
• Straighten the gaze (aesthetic improvement): through surgery in most cases or with glasses in the event that the strabismus is caused by hyperopia.
• Return binocular vision: so that both eyes work and see correctly.