Squint & Lazy Eye

Squint, also known as strabismus, is a condition where the eyes do not point in the same direction. Instead of looking straight, one eye turns inward, outward, upward, or downward. Squint can be present at birth but can also develop in childhood, or even in early adulthood. 

• Misaligned eyes: One or both eyes consistently or intermittently point in different directions (inward, outward, upward, or downward). 

• Tilting the head: Frequently turning the head to one side to try and focus with both eyes. 

• Squinting or closing one eye: Especially in bright light, individuals may squint or close one eye to see more clearly. 

• Double vision (diplopia): Seeing two images of a single object. 

• Eye strain and headaches: Difficulty focusing can lead to eye strain and headaches, particularly at the end of the day. 

• Poor depth perception: Difficulty judging distances accurately. 

• Blurry vision: In some cases, vision may be blurry.

• Cover test: The doctor covers one eye and watches the other for any movement to maintain focus. When the cover is removed, they observe how the covered eye moves to re-focus. 

• Visual acuity test: This test uses charts with letters or pictures to determine how clearly each eye sees at different distances. 

• Corneal light reflex test: A light is shone into the eyes, and the doctor observes the position of the light's reflection in each pupil. A misaligned reflection indicates a potential squint. 

• Refraction test: This test identifies vision problems like farsightedness or nearsightedness that may be contributing to the squint. 

• Retinal examination: A special lens is used to look at the back of the eye to rule out any structural issues. 

• Eye movement test: This assesses the strength and coordination of the eye muscles in different directions. 

• Family history: Having a family member with a squint significantly increases the risk. 

• Refractive errors: Uncorrected farsightedness (Hypermetropia), near-sightedness (myopia), or astigmatism can cause squint.

• Muscle imbalance: The muscles that control eye movement may not work together correctly. 

• Neurological disorders: Conditions that affect the nerves controlling eye muscles, such as cerebral palsy or stroke, can lead to squint. 

• Other medical conditions: Diseases like thyroid eye disease, or developmental conditions such as Down syndrome, are associated with squint. 

• Infections: Viral infections, high fever, or other severe childhood illnesses can weaken eye muscles or affect the nervous system. 

• Birth and pregnancy factors:

• Premature birth and low birth weight are associated with a higher risk. 

• Maternal smoking during pregnancy increases the risk for the child. 

• Injuries:Trauma to the eye or the surrounding area can cause misalignment. 

• Glasses : Corrective glasses, especially those with prism, can sometimes correct squint, particularly if linked to refractive errors. 

• Patching : Covering the stronger eye (patching) helps to strengthen the weaker, squinting eye and improve vision. 

• Vision Therapy : Exercises that enhance brain-eye coordination and muscle control. 

A common and effective treatment where eye muscles are repositioned to align the eyes. 

• Painless: Squint surgery is performed under anesthesia, so it is generally painless. 

• Safe: The surgery is considered safe and does not increase the risk of losing vision. 

While squint surgery is a highly effective treatment and often provides a permanent solution, the eyes may drift again over time, requiring further procedures in some complex cases.

Amblyopia (Lazy Eye): The most significant risk is the development of a lazy eye, where the vision in the squinting eye becomes permanently reduced. 

• Double Vision: The brain struggles to process images, which can lead to double vision. 

• Reduced Binocular Vision: This affects the brain's ability to use both eyes together effectively. 

Amblyopia is an eye condition that affects the ability to see clearly one out of both eyes.

 It usually develops when a child is an infant or very young and can get worse over time if it’s not treated.

If a child has amblyopia, one of their eyes has blurry vision and the other has clear vision.

Their brain starts ignoring their blurry eye and only uses the eye with clear vision to see.

 As their brain relies more on their stronger eye, their weaker eye’s vision becomes even worse over time. 

Amblyopia is a serious medical issue that needs treatment from an eye care specialist.

• Poor vision in one eye

• Squinting or frequently closing one eye

• Poor depth perception

• Misaligned eyes (strabismus), where one eye drifts up, down, in, or out

• Drooping of one eyelid (ptosis) 

• Consistently tilting the head to see better

• Frequent tripping, falling, or bumping into objects

• Poor hand-eye coordination

• Difficulty with tasks that require depth perception, such as playing sports

• Frequent eye rubbing or visual fatigue

• Headaches 

• Comprehensive eye exam: The Doctor will perform a complete eye exam to check overall eye health, including looking at the inside of the eyes. 

• Vision tests: Visual acuity (clarity) is tested. For older children and adults, a Snellen chart is often used. For infants, tests may involve checking their ability to follow a moving object. 

• Cover test: This test is used to check for eye misalignment, or strabismus, by covering one eye at a time to see how the other eye moves. 

• Refractive error assessment: Tests like retinoscopy or a cycloplegic refraction (using dilating eye drops) are performed to identify any refractive errors like near-sightedness or farsightedness that could be causing the amblyopia. 

• The doctor will also evaluate eye muscle strength, focus, and look for any other conditions that could affect vision, such as cataracts. 

• Regular eye exams are crucial: Routine eye exams, especially in children between 6 and 12 months old, are key for early detection.

• Report concerns: Tell your doctor if you have noticed any changes in a child's head position or how they interact with their surroundings, though many cases are diagnosed before symptoms are obvious. 

• Strabismus: Misalignment of the eyes, where one eye turns inward, outward, or up. 

• Anisometropia: A significant difference in focusing power between the two eyes, causing one eye to be much blurrier. 

• Refractive errors: Conditions like high myopia (near-sightedness), hyperopia (farsightedness), or astigmatism. 

• Structural eye problems:

• Cataracts or clouding of the lens 

• Ptosis (a droopy eyelid) that blocks vision 

• Corneal issues 

• Lesions or other problems on the retina 

• Genetics and family history: A family history of amblyopia or childhood cataracts increases risk. 

• Prematurity and low birth weight: Being born prematurely or having a smaller size at birth is a risk factor. 

• Developmental disabilities: Some developmental disabilities can be a risk factor. 

• Early Treatment is Key: 

• If left untreated, lazy eye can lead to permanent vision loss.

• Patching: Covering the stronger eye forces the brain to use the weaker, "lazy" eye. 

• Glasses or Contact Lenses: Correcting refractive errors helps the brain receive clearer images from that eye.