This generally occurs because the muscles that hold the movement of the eye and the eyelid, the extraocular muscles, aren't working in cordination with each other or the eyelid. It can also happen from an detriment or injury to the brain, which impacts the eye’s capability to work together. However, also it's compulsory to evaluate the child at the foremost. If the eyesight is affected. Utmost squints in kiddos need to be estimated as soon as achievable to forestall the strike of lazy eye and to enhance the chances of successful outcome of treatment. Still, an eyepatch may be needed over the good eye to promote use of the squinting lazy eye, If the child formerly has lazy eye. The type of squint , treatments options include spectacles , eye exercises when applicable, and sometimes surgery or neuromodulators to operated muscles.
Squint is evaluated by varied orthoptics test, the aim of which is to:
1. demonstrate and measure the amount and type of Squint in the eye
2. interpret how easily can the Child/ Adult see i.e, Refraction
3. Test for Binocular Vision - Convergence, accomodation, stereopsis (depth perception), sensory fusion , worth four dot test
4. Fundus test to rule out any torsion
The most frequent treatment for squints in grown-ups is eye muscle surgery, as the eye is already grown and the visual potential is difficult to recover at older age. the eye surgery in adults is mostly cosmetic and occasionally functional improvement is seen. In children, the treatment involves prescription of glasses and lazy eye tretment with patching therapy or binocular video based exercises like Amblygo/ CureSee/ Revital for improvemnt in vision, contrast and stereopsis.
Surgery for squints involves weakening or tightening of the muscles depending on the type of squint. In children it is done under general anaestehisa vis-a-vis adults where it can be performed under local anaesthesia. The surgery takes around 10 - 15 minutes per muscle depending upon the number of muscles invoved, average of 30-60 minutes. The child is uncomfortable for the first 2 postoperative days due to stretchy feeling of the operated muscles as the child moves the eye. Everyone is comfortable after the first 2 postoperative days but the redness in eye persistes for 2-3 weeks , which eventually goes away after putting the eye drops. Some people may perceive double vision after squint surgery due to alignment of eyes and the brain takes a little while to adapt to this change.
Child Eye Specialist examine squint type and there are numerous tests for squint eye like:
- Visual/ Optical acuity testing
- Corneal light reflex
- Cover/ Uncover Test
- Prism cover test
- Convergence/ Accommodation
- Extraocular movements
- Stereopsis (Depth perception)
- Fusion
- Brain and Nervous System testing
Specialist Services offered by Child Eye Specialist
- Vision evaluation and refraction under dilation
- Squint estimation and evaluation of binocular vision
- Amblyopia remedies
- Synaptophore helped eye exercises for stimulating the eye muscles and binocular vision.
- Regulation of all childhood infections and allergies
- Trauma services
- Test under sedation or anesthesia, if required in unco-operative and challenged children.
- Comprehensive pre-anesthetic check- up and post-operative care.
- Eyeglasses and low vision aids
- Surgical and medical guidance of childhood and natural diseases, as indicated natural cataract, natural ptosis, glaucoma and squint .
- Vision- related problems similar as diplopia or double vision.
Sometimes , squints can occur from conditions affecting the eye muscles similar as fractures of the eye socket, or in unspecified brain conditions which affect nerves outfitting the eye muscles. Squint is one of the frequent eye troubles seen in kiddos and must be treated on crisis basis as it may lead to amblyopia or lazy eye and eased stereovision ( 3D vision) if left untreated. The main aim of treatment is to revive vision, uncurl the eyes and assay to revive binocular vision and stereopsis. This treatment needs to be succeeded in a progressive manner.
