Squint And Orthoptics

Commonly asked questions ?

There are three basic types of squint-
Esotropia or Crossed eyes.
Exotropia or divergent eyes.
Hypertropia or Vertical squint.

The symtoms of a squinting eye are-

  • Turned or crossed eye
  • Squinting
  • Head tilting or turning
  • Double vision (in some cases)

The disadvantages due to a squinting eye are-

  • Defective binocular vision

    The eyes need to be straight for images seen by the two eyes to be fused. This gives accurate vision and stereopsis, or 3-D vision; 3-D vision is used to judge depth.

    PICTURE DEPICTING WHEN 2 EYES NOT WORKING IN COHERNCE TOGETHER, IT LEADS TO DEPTH PERCEPTION PROBLEMS AS IN SQUINT.

  • Reduction of vision in the turned eye (amblyopia) A reduction of vision may occur in one eye in squint, especially under certain circumstances, such as late treatment. If this condition is not treated urgently, vision may be reduced to partial sight (legal blindness) in the turned eye. If treatment is begun immediately, however, perfect vision can often be restored.

Sometimes surgery is the only way of straightening the eye sufficiently for sight to be restored in the squinting eye. If performed at the appropriate time, results can be very good and satisfactory and Three Dimensional vision can be developed. However, when the results are only cosmetic, they improve the child’s appearance only. It is sometimes possible to do more than one operation to achieve the desired results.

It involves repositioning the relevant eye muscles on the eye ball. This could mean either shortening or loosening of muscles with surgery.

LENGTH OF THE EYE MUSCLES MODIFIED DURING SURGERY

Squint surgery is a day care procedure where the patient is sent home on the day of surgery itself. The eye may appear red after surgery, but this settles down in a few weeks. One should be able to return to school after about 10 days of surgery. If the child wears the spectacles before the operation, spectacle will still be needed after the surgery.

Amblyopia, also known as “lazy eye,” is reduced vision – uncorrectable with lenses in an eye that has not received adequate use during early childhood.

There is no visible anatomical defect. Amblyopia has many causes. Most often it results from either a misalignment of a child’s eyes, such as crossed eyes (strabismus), or a difference in image quality between the two eyes (one eye focusing better than the other, also known as anisometropia).

In both cases, one eye becomes stronger, suppressing the image of the other eye. If this condition is not treated in early childhood, the weaker eye may become permanently impaired.

With early diagnosis, amplyopia can be treated and loss of vision prevented.

Amblyopia can often be reversed, or at least reduced, if it is detected and treated early. Cooperation of the patient and parents is required to achieve good results.

If left untreated or if not treated properly, the reduced vision of amblyopia becomes permanent and vision cannot be improved by any means.

The most effective way of treating amblyopia is to encourage the child to use the amblyopic eye. Covering or patching the good eye to force use of the amblyopic eye may be necessary to ensure equal and normal vision. This can be achieved by:

  • Prescribing proper spectacles if the patient is found to have refractive error or accommodative esotropia.
  • Prescription of drops such as Phospholine Iodide to reduce the accommodative effort that causes accommodative esotropia.
  • Removal of cataract when indicated.
  • Occluding the normal eye, for example, with a patch.
  • Surgery, when amblyopia is accompanied by strabismus and is unresponsive to conservative treatment.

PATCH OCCLUSION USED AS TREATMENT OF AMBLYOPIA

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