WHAT IS SQUINT: Squint or strabismus is a condition in which the visual axes of the eyes are not parallel and the eyes appear to be looking in different directions, or simply, crossed eyes.
Inward deviation of the eye or eyes is called esotropia and outward deviation is called exotropia. There are various causative factors like genetic or hereditary, neurological, pre-maturity, high spectacle number, or injury (to the head or eyes). No two patients with squint are exactly alike and each patient requires a thorough evaluation and proper treatment by a specialist.
There are several myths related to the perception and treatment of squint especially in children, in whom early evaluation and treatment is crucial. The following is an attempt to state the facts from a scientific perspective:
MYTH 1: SQUINT IN SMALL CHILDREN GOES OFF ON ITS OWN:
FACT : Except in very rare cases, squint does not disappear on its own. This is a popular belief harbored by many parents and re-inforced by some doctors too. This leads to unnecessary delay in treatment and consequently permanent loss of vision in one eye in the child. Squint should be evaluated as soon as diagnosed as only timely intervention can preserve vision and 3 D vision in the child. So remember, NO ‘WAIT AND WATCH’!
MYTH 2: SQUINT IS JUST A COSMETIC PROBLEM
FACT: In addition to it being a cosmetic problem, it more importantly is a functional problem as every day of untreated squint means compromise of the full visual potential in the child. Early treatment of squint is not only to straighten the eyes for cosmetic reasons, but to prevent deterioration of vision and binocularity. Binocularity is the condition in which both eyes work together to achieve 3 dimensional vision and depth perception. This has implications in many day to day activities like driving, appreciating 3 D movies, as also in many careers like aviation, military, stereoscopic surgery etc. Lack of binocularity reduces the field of vision and renders the patient more susceptible to injuries. A patient with squint is actually looking at the world with only one eye at a time, hence the vision of the squinting eye can get severely and permanently reduced leading to a lazy eye. Squint can also be a manifestation of serious underlying disease in the eye, like a tumour, cataract or infection, and hence needs prompt attention.
MYTH 3: THERE IS NO TREAMENT FOR SQUINT:
FACT: Depending on the type of squint, there are many treatment options like glasses, eye patching in which lazy eye is made to work more as compared to normal eye, vision therapy exercises like synaptophore, prisms and surgery. Any one or a combination of these treatment modalities may have to be used depending upon the case. Treatment of squint is long term and yield successful results, so commitment and co operation of the parents is as important as the doctor’s skill. Squint can be treated at any age, even in adults, but treatment done in childhood gives the best results.
MYTH 4: SQUINT SURGERY WILL CAUSE DAMAGE TO THE EYE
FACT: Squint surgery is one of the safest eye surgeries as it is extraocular (does not involve opening or entering the eye like in cataract surgery). Only the muscles on the white portion of the eye are tightened or loosened and there is no damage to vision or permanent scar visible after surgery.
MYTH 5: SQUINT WILL RECUR AFTER SURGERY
FACT: This is more of a fear in parents’ minds which prevents them from going in for the surgery. With proper pre operative evaluation and operative technique, the chances of recurrence in childhood squint are very less. More harm will be caused by not doing the surgery than the recurrence if it occurs at all. Recurrence after surgery may occur after many years and there are non surgical and surgical options to treat that as well.
MYTH 6: MY CHILD IS TOO SMALL TO UNDERGO SURGERY
FACT: The earlier your child is treated for squint, be it with glasses or surgery, the better results you will get. Now a days, general anaesthesia techniques are very safe, and the surgery itself carries hardly any risk. So no child is too young for surgery if surgery is indicated. Remember that timing is critical for proper visual development, so do not delay surgery if it is required for your child’s benefit.
In conclusion, parents and doctors have to work hand in hand and take adequate and early measures to prevent avoidable blindness or visual impairment caused due to squint.