November 15, 2024

Squint /strabismus or commonly known as ‘cross eyed’ is a condition of the eyes where there is a misalignment between both eyes. More simply speaking, in this condition when one eye looks straight the other eye is deviated outward, inward, upward or downward. This condition can present at any age , though many patients are affected from infancy or early childhood. 

The most common causes of strabismus in childhood or infancy are Decreased vision in one or both eye due to various conditions like congenital/developmental cataract, retinal issues like retinopathy of prematurity, optic nerve disorders.

Refractive errors where child has to use glasses Certain syndromes and neurological disorders 

Idiopathic/ genetic

When an adult presents with squint on the other hand, it may be a childhood squint that was left untreated or it my be due to other causes like paralysis of the nerves supplying the extraocular muscles in case of uncontrolled diabetics or neurological issues, thyroid disorders and trauma to the eyes.

The presenting symptoms of squint are

Appearance of squint in one or both eyes alternatively 

Abnormal head posture 

Decreased vision in one or both eyes

Asthenopic symptoms like headache 

Diplopia or double vision in some cases.

The treatment of squint is largely based on the cause. One of the common myths around squint in our society is that it's just a cosmetic blemish which may not be treated. Many infact consider squint as a lucky charm and refrain from getting treatment for the same. Another misconception is that there is no need for correction of squint in childhood and treatment can wait till the child becomes older . This is unfortunately incorrect. If squint is left untreated in a child , it can lead to amblyopia or lazy eye and inadequate development of stereopsis, depth perception and three dimensional vision. Therefore it is best to treat squint at the earliest . However when it’s left untreated, it can also be treated in adulthood for the purpose of cosmesis. Sometimes squint also needs to be treated to address double vision in both children and adults 

Treatment of squint involves treating of cause like removal of any cataract, treatment of refractive error with glasses, patch therapy , home based or computer based exercises , prisms for diplopia and surgery 

Surgery in squint requires realignment of extraocular muscles. This surgery is usually a day care procedure . In children general anaesthesia may be needed for surgery , but in adults it can be done under local anaesthesia. Surgery in squint is known to be predictable and safe

In conclusion, squint is a common eye problem which can easily be treated. Anyone having this condition is advised to contact an ophthalmologist preferably a strabismus specialist at the earliest.