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It is an eye condition where there is a misalignment between the two eyes of a person such that they appear to be looking in different directions. It varies from case to case, with some conditions appearing permanent and others looking misaligned only sometimes. Although it is more common amongst children, it occurs in adults too.

What causes Squint?

The root cause of squint still remains undecided amongst experts. This condition develops when there is a lack of coordination between the muscles responsible for maintaining proper alignment of the eyes. Each eye is equipped with six such muscles for alignment, and malfunctioning amongst any of them can lead to squint. The misalignment could be greater in one direction of the gaze (like in squint due to nerve palsy) or it may be in all directions.

Long-sightedness (hypermetropia) and eye disease like cataract can sometimes result in an inward deviation of the eye. It's important to have a thorough checkup for all cases of squint, especially those among children. This will help eliminate any other cause of vision loss.

What problems arise from Squint?

Since misalignment between the two eyes results in two different images being sent to the brain, confusion prevails and can lead to either of the following two effects:

  • Children would tend to ignore the image from the deviated eye and would thus see only one image. However, this would cause loss of depth perception. This suppression of image from the deviating eye causes poor development of vision in the affected eye, giving rise to amblyopia.
  • Amongst adults, on the other hand, the brain does not ignore any image, causing the patient to see two images. This can be very annoying and also leads to interference during work.

What are the symptoms of Squint?

Parents can usually notice a deviation in the eyes of their children. It must be noted though that newborn rarely have perfectly aligned eyes and take about 3-4 weeks to stabilize. A squint in children above the age of one month needs attention and must be evaluated by an ophthalmologist. In adults, the giveaways could be misaligned eyes or double vision.

How to diagnose squint?

An ophthalmologist would have to conduct special tests to establish the cause and quantify the amount of deviation. Some children have a broad nasal bridge, leading to the appearance of a "false squint". Only an ophthalmologist would be able to differentiate a "true squint" from a false squint.

What is the treatment for Squint?

Listed below are the objectives, in order of importance, in any treatment of squint-

  • Preserving or restoring vision
  • Straitening the eyes
  • Restoring binocular vision

The primary focus is to treat any refractive error if it is leading to squint. Often, a correction of this error may be all that is required to treat this condition, termed "accommodative squint". Next, the eyes are checked for the presence of amblyopia, which must be treated before any surgery for squint is performed. The importance of treatment has to be communicated to parents as their cooperation is essential in such cases.

Finally, squint surgery can be done on either one or both the eyes. It involves weakening or strengthening of the relevant muscles to restore balance and coordination. In some cases with double vision, prisms may be added in the glasses to ease the symptoms.

When should the Squint be treated?

The treatment of squint and any associated amblyopia is recommended at the earliest possible opportunity amongst children. Generally, the younger the age at which amblyopia is treated the better are the chances of vision recovery. One needs to know that there is no such thing as "growing out of squint". A delay in treatment may decrease the chances of restoring alignment and vision for the patient.

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