SQUINT IN CHILDREN
Squint is a condition in which the eyes are not properly aligned
i.e. one eye is straight and the other is turned away from the straight
position.
A horizontal squint is “convergent” when the deviated
or the abnormal eye is turned inwards and “divergent”
when it is turned outwards. A “vertical” squint is one
when the abnormal eye is turned up or down.
Squint can occur at any age. They can be constant, that is, present
all day, or they can be intermittent and therefore occur at different
times during the day; especially when the child is tired or unwell.
BINOCULAR VISION
It is only when we have both eyes straight, we can use them together
as a pair and see things in three dimensions. This is called binocular
vision.
AMBLYOPIA (LAZY EYE)
When a child has squint, he uses only his straight or normal eye
to see. Vision in this eye develops normally. The squinting or deviated
eye is not used.
When a child has a constant squint, constant disuse of the squinting
eye causes decreased vision in that eye. Hence the squinting eye
becomes lazy. This is called Amblyopia. Amblyopia is, therefore,
vision in an eye that is not used constantly.
TREATMENT
Amblyopia is potentially fully correctable by appropriate treatment.
The success of treatment is mainly dependent on the age of the child
and the degree of amblyopia. The younger the child, the easier and
quicker the recovery. Amblyopia treatment is usually not effective
after the age of 10-12 years.
SURGERY
After Amblyopia has been treated, some children will still need
surgery on the eye muscles to put their eyes straight so that they
can regain binocular vision. However, binocular vision can only
be regained when the child is young.
In older children, when the squint has been present for a long time
and binocular vision is not possible, the squinting eye can be put
as straight as possible to improve the child’s appearance.
Not all children with squints require surgery. Some squints can
be prevented or helped by wearing of glasses.
MYTHS AND FACTS
| Myth |
“All babies squint”. |
| Fact |
They do not. Although the eyes are initially uncoordinated,
control of eye movements is achieved by approximately 3 months
of age. |
| Myth |
“Children under the age of two years cannot be examined.” |
| Fact |
No child is ever too young to be examined for squint. If squinting
is evident, then early appropriate action can be taken. |
| Myth |
“Even if squint is present, no harm will occur if it
is left alone; the child will grow out of it”. |
| Fact |
Harm will occur. The child can suffer gross loss of vision
(Amblyopia) in the squinting eye and this may become permanent
if neglected. He may even lose the chance of achieving binocular
vision. |
| Myth |
“As long as the squint is only a tiny one, it really
does not matter”. |
| Fact |
A small squint is as likely to result in Amblyopia and defective
binocular vision as a large squint. Therefore, it must be examined
as quickly as possible for correction. |
| Myth |
“A squint operation means the child can leave his glasses
off afterwards”. |
| Fact |
Surgery will only alter the position of the eyes. It does
not correct refractive errors. |
Early treatment of squint helps to restore good vision and allows
your child to use both eyes together.
|
