|Squints in Children
There are certain conditions where there may be a ‘false or pseudo squint’. There may be a wide gap between the eyes or a flat nose bridge that can give the impression of misalignment. Newborn babies sometimes have misaligned eyes which adjust themselves after six months. In any event, an examination by an eye doctor will establish the true situation.
What causes squints in children? Some are born with it (a congenital squint) or they may be long-sighted. The extra effort needed to focus may produce a convergent squint and double vision. Childhood illnesses such as viral fever, measles and meningitis may also cause the eyes to squint. Then there is always the possibility of injury to the nerves that supply the eye muscles.
Children who have a constant squint cannot use the squint eye to see and will therefore develop poor vision. The eye is called ‘lazy’ or amblyopic. Those children also cannot appreciate depth (called stereovision). A natural reaction may be for the child to adopt an abnormal head position like a tilt or face turn in an effort to keep both eyes aligned.
Once the eye doctor is alerted to the squint, he or she can monitor the condition closely to ensure that the vision in the squinting eye is developing normally. In some cases, such as long-sightedness (hypermetropia) squints in children can be treated by wearing glasses. As the child grows, spectacle power is adjusted appropriately. If any squint remains after a certain age, it can be corrected by eye muscle surgery.
There are many cases where one eye is weaker than the other. This is called ‘lazy eye’ or amblyopia. Children of 9 or earlier (when the visual system is still developing) can improve their condition by having the good eye patched while they do visual activities such as painting or reading. This trains the weak eye to work harder. If the squint persists into later childhood then surgery may be the only solution to straighten the eyes.
Surgery is a relatively simple procedure to correct squints in children. The thin transparent layer of tissue that that covers the white of the eye is called the conjunctiva. The surgeon lifts this to reveal the muscles that control eye movement. The muscles that control the eye position are then adjusted: one muscle is weakened by moving it towards the back of the eye and the other strengthened by shortening it. Now the eye appears straight. The conjunctiva is sewn back in place using dissolvable stitches.
Following the operation, any discomfort may be alleviated by taking simple painkillers. The eye will be red but will ‘settle down’ over several weeks, aided by eye drops or ointment. The eye will be red, but should improve gradually over several weeks. Eye drops or ointment will help the eye recover. Your child will need to recover at home for the first week and avoid swimming for two to four weeks. If the squint is severe, more than one operation may be required.
Eye surgery techniques today have improved vastly and the chances of children with squints having normal-looking eyes are excellent. Cosmetic correction can be relatively easy to achieve. However achieving perfect functional results might involve more than one operation as progress is assessed and in some cases is not possible, depending on the cause.