Squint or strabismus is a medical condition affecting the proper alignment of the eyes. The one eye is looking at the object while the other eye may be turned away in any direction away from the center. It can be present from birth or may be acquired later in life. If not treated, child may later develop amblyopia which is a serious vision threatening condition.
It occurs in approximately 2 to 4 percent of the population.
Squint can be of various types on the basis of direction of misalignment of the eye ball as
These conditions may occur in combinations too and with varying degree of misalignment.
The misalignment is easily detectable gross sign of this disease. Apart from this there can be other symptoms which are not easily detectable as
Adults having squint may report following problems
Many adults with squints turn or tilt their heads to get the better focus of the image.
Movement of eyeballs in the socket is controlled by a group of muscles and nerves controlling them. The major causes of squint are related to the dysfunction of these muscles or injury to the nerves.
There are some conditions which causes an increased risk of developing strabismus though the cause is not much clear
Squint can also begin in adulthood due to medical conditions like
It is seen that squint can be a presenting sign in some diseases such as retinoblastoma.
It is important to differentiate between congenital and acquired strabismus because acquired strabismus can be caused by life threatening or vision threatening conditions. Squint can be easily detected with simple clinical tests. It is important to detect if child is developing amblyopia or not.
Additional evaluation may be needed based upon the history and the physical examination which can include blood tests or imaging procedures.
The management of squint is based on the treatment of underlying cause. The main aim of treatment is restoring the normal vision of the patient. General management principle of squint are as follows
Restoring vision: if the child is suffering from vision impairment due to any cause. It is treated first as vision impairment can cause amblyopia. It may include spectacles for refractive error. Surgical procedures for conditions like cataract can be needed in some patients suffering from it. If one has already developed amblyopia then the occlusion therapy may also need to be started which involves covering up of the normal eye so that brain is compelled to interpret images seen by the affected eye.
Correcting the misalignment: both surgical as well as nonsurgical options are available. Nonsurgical options include prescriptions of prism therapy, eye drops and visual training exercises. Botox injections are indicated to relax the muscles when no apparent cause is identified. Surgical treatment for the strabismus is the last approach when other management options fails to cure it. Muscles surrounding the eye are detached from the original positions and attached to different spot depending upon the degree and plane of misalignment.
This post was last modified on December 21, 2020 12:18 pm
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