What is a squint?
A squint, or strabismus, occurs when the
eyes do not align properly because one of them turns in or out, up or down,
while the other looks straight ahead. In adults, if it occurs due to an
accident or illness, it can cause double vision or blurring of vision. Children
with a squint can develop a lazy eye because the brain completely ignores input
from the out-of-line eye.
Squints affect around 5% of children, and
occur most often in their pre-school years. A child can be born with a squint
or the condition can develop later as the muscles fail to develop properly, or
Squint surgery is used to balance the
muscles that control the movement of the eyes. In many cases, the surgeon will
need to work on the muscles of both eyes to achieve the best balance.
The selected eye muscles are detached and
either shortened, to increase their effect, or moved forwards in the eye
socket, to decrease their effect, before being sewn back into place with
Squint surgery is performed under general
anaesthetic, and you will normally be able to stay with your child until the
anaesthetic takes effect, and return before they wake up, so they will feel
like you have been with them throughout.
What to expect after squint surgery
As you would expect, the eye will be sore
after squint surgery, and the stitches can feel gritty and irritating. However
it is important to stop your child from rubbing their eye during this time if
you can. The stitches will dissolve in around six weeks.
There is no need to wear a dressing or eye
patch, even if the eye seems red or sore, as it is important to get the eyes
working together again as quickly as possible.
Your child should be able to return to
nursery or school after about a week, but extra care should be taken for at
least a fortnight, including:
Avoiding playing in sand or mud.
Avoiding getting shampoo in the eyes.
Not using face paints.
Avoiding sports, especially contact sports,
and rough play.
Risks and complications of squint surgery
Squint surgery is a common and routine
operation with very few risks. However, as many as 60% of children who have an
early operation, around age one, will require a further operation as they get
older. In adults, only 20% will require further surgery.
Other risks are rare, but include:
Prolonged red eye caused by scar tissue.
Double vision for up to a fortnight.
A detached muscle that has slipped its
stitches, causing the eye to go off line.
Damage to the inside of the eye.
An infection at the wound site.
Alternatives to squint surgery
Squints should be treated promptly once
they have been diagnosed, as the vision problems they cause will only get worse
and may become permanent. However, before squint surgery is recommended, your
ophthalmologist will try alternative treatments to try and cure the squint.
Corrective glasses - to resolve sight
Eye exercises - to train the muscles.
Botox injections – to rebalance the
Getting very small children to wear glasses
or perform eye exercises can be difficult while Botox treatments may only last
a few months before the squint returns. In many cases, surgery is the most