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Strabismus (Squint)

What is strabismus (squint)?

Strabismus is a condition where one eye looks straight while the other eye turns away from the straight position. The squinting eye can turn inwards (a convergent squint), or outwards (a divergent squint). A squint can also be vertical with one eye higher than the other.

When a child has a constant squint, he or she may develop amblyopia (lazy eye). The condition may also limit binocular vision or stereovision (3-dimensional vision).

Causes of strabismus

Strabismus can be due to a disorder of the brain’s co-ordination of the eyes, a disorder of one or more of the muscles controlling the eye, or a disorder within the bony-orbit around the eye. Strabismus can also occur if vision in one eye is poor (e.g. due to lazy eye, cataract or other abnormalities within the eye). For this reason, it is important that parents bring their children for an eye examination if they have a squint.

Examples of squint eyes - Singapore National Eye Centre

Symptoms of strabismus

Most often, parents will notice that the eyes do not appear to be working well together. Some children adopt an abnormal head position like tilting the head or turning the face to try to keep both eyes aligned.

Many Asian babies appear to have a convergent squint when a fl at nose bridge coupled with folds of skin cover the inner part of the eyes. If a true squint is not present after a medical examination, it is called a pseudo-squint and no treatment is necessary.

Prevention of strabismus

In most cases of strabismus in children, the cause is unknown. In more than half of these cases, the problem is present at birth or develops shortly after birth. Strabismus cannot be prevented, but it can be corrected with early intervention.

Treatment of strabismus

If there is existing amblyopia (lazy eye), then this condition must be treated fi rst. This can be achieved by Strabismus can be corrected with early intervention. Many Asian babies appear to have a convergent squint when a fl at nose bridge coupled with folds of skin cover the inner part of the eyes. If a true squint is not present after a medical examination, it is called a pseudo-squint and no treatment is necessary. patching the good eye, so that the child is required to use the ‘lazy’ eye. When vision is normalised, the child will use each eye equally and the squint will alternate between the eyes.

For a young child with a constant squint, the condition can be corrected with surgery to realign the eyes and allow binocular and 3-dimensional vision to develop. For a child with intermittent squint, surgery is not as urgent as he or she is capable of binocular vision some of the time.

Some squints can be caused by uncorrected long-sightedness (hyperopia) or short-sightedness (myopia). Glasses can sometimes reduce or completely eliminate the squint and the need for surgery. It is important to seek early treatment for good outcomes.