Squint Eyes Treatment

Squint eyes is a condition when a person’s eyes look in different directions. A squint is known by various other names, such as “crossed eyes” and strabismus. It often affects children but can occur at any age. Let’s find out all about squint eyes, its causes, symptoms, diagnosis, treatment, and prevention. 

Squint eyes is a condition in which both eyes are unable to look at the same spot at the same time. So, one eye is turned in a direction different from the other eye. It is known commonly as “crossed eyes” and medically as “strabismus”. 

Individuals with squint eyes have problems controlling eye movement and cannot keep normal eye alignment.

There are different types of strabismus or squint eyes based on the direction of the misaligned eye. 

• Hypertropia: One eye turns upwards, while the other remains straight
• Hypotropia: One eye turns downwards, while the other remains straight
• Esotropia: One eye turns inwards, while the other remains straight
• Exotropia: One eye turns outwards, while the other remains straight

The two most common types of strabismus or squint eyes seen in children and adults are:

• Accommodative Esotropia: This type of squint eye often occurs in individuals with uncorrected farsightedness or hyperopia. Farsighted people have to focus extra hard to keep images clear, which causes the eyes to turn inward.
• Intermittent Exotropia: In this type of squint eye, one eye looks straight at a target while the other eye is pointing outward. As the name suggests, in this type of squint, eye misalignment occurs only at certain times or intermittently, such as when the person is tired or looking at a distant object.

Squint eyes are caused due to problems with the eye muscles, the nerves that transmit information to the muscles, or the control center in the brain that directs eye movements. Experts are still trying to understand why this happens. Squint eyes are inherited in a lot of cases and in others, they may develop later in life.

Under normal circumstances, six different muscles surround each eye and work together to allow both eyes to focus on the same object. In an individual with squint eyes, these muscles do not work together. As a result, one eye looks at one object, while the other eye looks at another object in a different direction.

Thus, each eye sends a different image to the brain and confuses it. In children, the brain may learn to suppress the image from the weaker eye.

The possibility of developing squint eyes may increase due to the following factors:

• Family history of squint eyes
• An eye injury or disease
• Damaged retina
• Uncorrected refractive errors such as farsightedness, nearsightedness, or astigmatism
• Poor vision in one eye
• Brain tumors
• Stroke
• Head injuries
• A lesion on a cranial nerve, a nerve that sends information between the brain and the sense organs
• Hydrocephalus, a condition that results in buildup of cerebrospinal fluid in and around the brain
• Graves' disease, a condition in which there is overproduction of thyroid hormone

In rare cases, a squint may develop because of :

• Infections such as measles
• Genetic conditions such as Down's syndrome and Noonan syndrome
• Developmental delays
• Neurological problems
• Cerebral palsy, a group of disorders that affect movement and posture
• Retinoblastoma, a rare type of childhood eye cancer

Common signs and symptoms of a squint or strabismus include:

• Eyes pointing or focusing in different directions
• Uncoordinated eye movements
• Blurry vision
• Double vision
• Vision in only one eye
• Problems with reading
• Decreased perception of depth
• Eyestrain
• Headache
• Weakness in or around the eye
• Constantly tilting or turning the head to see an image clearly
• Frequent blinking or squinting, especially in bright sunlight

An eye doctor can diagnose squint or strabismus in a child or an adult through a complete eye examination.

The tests included in the diagnosis of squint eyes are: 

• Visual Acuity Test: This test involves examining young children’s visual behavior. In adults, it includes checking vision based on how well an individual can see different-sized symbols on a chart. 
• Refraction Test: This test can be performed on children and adults alike. It is meant to check how your eye focuses light as it enters. A device called a phoropter is placed on the eyes and different lenses are added to it. The individual is then asked to read an eye chart with each lens.
• Corneal Light Reflex Test: Also known as the Hirschberg test, this is a test specifically to check for squint. The eye doctor shines a light in the eye and observes where the light reflects from the corneas.
• Cover-Uncover Test: During this test, a person is asked to look straight ahead while the eye doctor covers one eye with a small occluding card. The doctor then watches the uncovered eye to see if it moves or shifts to focus on an object. After a few seconds, the card is removed, and the same process is repeated on the other eye. 

Inner Eye Examination: In this test, the pupils (the dark circles in the center of the eye) are dilated or widened with special eye drops and then examined to determine the health of internal eye structures.

Treatment options for squint eye or strabismus include:

• Eyeglasses or Contact Lenses: This treatment modality is used for patients in whom uncorrected refractive errors are causing squint eyes. The corrective lenses in eyeglasses and contacts make focusing easier for the eyes and they may remain straight.
• Vision Therapy: Also called orthoptics, the eye exercises in vision therapy may be beneficial for individuals who experience strabismus intermittently. These exercises may help improve brain-eye coordination and muscle control to enhance focus.
• Prism Lenses: A prism is a clear, triangular lens that refracts light rays and can be attached to eyeglasses or made as part of the lens. Prisms can help reduce the amount of turning required by the eye to look at objects.
• Botulinum Toxin Injection: Also referred to as botox, this treatment modality includes injecting botulinum toxin into a muscle on the surface of the eye. Botox temporarily weakens the injected muscle and may help the eyes to align properly.
• Patching: Eye patches may be used to treat amblyopia or “lazy eye” if it occurs at the same time as squint eyes. The improvement in vision through patching may also improve control of eye alignment.
• Eye Muscle Surgery: It is only used if other treatments are not effective. This type of surgery changes the length or position of eye muscles so that the eyes are aligned properly and binocular vision is restored. In some cases, both eyes may need to be operated on. 

If left untreated, squint eyes or strabismus can cause problems such as: 

• A lazy eye or amblyopia, where the brain cannot recognize the sight from one eye
• Persistent blurred or double vision
• Eye strain and headaches
• Fatigue
• Poor 3-dimensional (3-D) vision
• Low self-esteem

Squint eyes or strabismus cannot be completely prevented. However, since squint eyes may develop because of various controllable factors, you can take these steps to reduce the risk of developing the condition:

• Take steps for early detection and treatment of vision problems such as refractive errors that could lead to the development of a squint.
• Wear corrective lenses consistently if you have vision problems so that the refractive errors are corrected and the risk of developing a squint is reduced.
• Maintain good eye health by taking regular eye checkups, wearing protective eyewear, and following an eye-health-friendly diet to prevent vision problems that can lead to a squint.

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