Squint eyes can be corrected
BRENDA Akello had a normal delivery. The mid-wife carefully examined the baby to ensure its body parts were fully developed. However, three months later, Akello noticed something odd about her baby’s eyes.
By Agnes Kyotalengerire
BRENDA Akello had a normal delivery. The mid-wife carefully examined the baby to ensure its body parts were fully developed. However, three months later, Akello noticed something odd about her baby’s eyes.
“Whenever I would pass an object in front of the baby, her eyes would roll in different directions. When I took the baby to hospital, I was told she had squints and would require an operation to correct them,†Akello narrates.
Dr. Grace Ssali, a paediatric eye surgeon at Mulago Hospital, describes squints as misalignment of the eyes or a condition where both eyes look at different points.
“The eye has six muscles responsible for controlling movement. When the muscles are uncoordinated, the eyes become misaligned,†Ssali explains.
She says squints can either be convergent (esotropia) or divergent (exotropia).
“A child with squints has double vision because each eye forms a different image. As a result, a child uses one eye, making the other eye lazy (amblyopia). If not treated before the age of nine, visual impairment becomes permanent,†Dr. Ssali warns.
According to Mulago Eye Department, about 10 to 12 cases of children with squints are registered every month, while Mengo Hospital registers about two to three squint cases in a month.
The challenge in managing squints in children is that most parents do not seek urgent medical help because of the misconception that squints correct themselves as the child grows.
But with early diagnosis and treatment, Dr. Cillasy Ruy Tumwesigye, a consultant Ophthalmologist at Mulago Eye Department, says squints can be corrected.
The child may also be saved from retinoblastoma (eye cancer). Correcting squints also boosts a child’s self-esteem and saves him from bullying from peers.
Cause and diagnosis
Dr. Ssali says a baby can be born with squints, or they can occur later in life from the age of three months.
Dr Rose Mutumba, an ophthalmologist at Mengo Hospital, says the cause of squints is unknown. She, however, notes that squints are common in children with other health challenges like those born prematurely, children with muscle control problems or any problem causing poor vision (short or long sight), problems with the brain, nerve disorders, traumatic brain injury at birth and children with cerebral palsy.
Other factors include hemangioma (a patch close to the eye or sometimes deeper), tumours in the brain or eye, retinoblastoma and cataracts.
“The eye specialist (ophthalmologist) will watch how the child looks around a room and then ask him or her to look at a source of light to find out if the light’s reflection is in the same position on each eye. Finally, the ophthalmologist covers one eye and watches how the uncovered eye moves, then uncovers it and watches how both eyes move,†explains Dr. Mutumba.
She adds that if the child is old enough, he or she will complain of not seeing well, having double vision or being sensitive to light. Besides, the examination of the retina is also done to identify any causes of squints, she explains.
How are squints treated?
Treatment of squints depends on the cause. Tumwesigye explains that glasses help to correct any refractive error.
He says for children who develop a lazy eye, ‘we patch one eye to strengthen the weak eye so as to regain vision’
Dr. Tumwesigye adds that if these methods do not correct the squint, an operation is considered.
Is surgery for squints available?
Dr Ssali says surgery for squints is offered free in hospitals like Mulago at the eye clinic in ward 1 A and Mengo Hospital. Alternatively, glasses are offered at a subsidised cost.
The operation is carried out under a general anaesthesia and takes about an hour. The eye surgeon works on the muscles connected to the eye so that they are either strengthened or weakened. The number of muscles moved depends on the type of squint. The child is able to see the next day after surgery.
Dr. Mutumba recommends that babies’ eyes be checked soon after birth and at intervals throughout childhood.
How I found out my baby had squints: Our readers had this to say...
Shamim Nambejja, the mother of six-month-old Shabirah Nagawa
Nagawa fell sick two days after birth. She developed a fever and started convulsing. She got squint eyes since then. When she turned three months, I took her to Mulago Hospital, but I was advised to take her back at six months for an operation. She has now been operated upon.
Agnes Namitala, the mother of one-year-old Martha Nanyonga
My family does not have a history of squints, but I noticed Nanyonga had the condition when she was about three months old. Whenever I put an object before her, her eyes would not follow it. When I took her to Mulago Hospital, she was started on treatment, but she did not respond. I was advised to wait until she turned one year so that the squints could be corrected by surgery.
Gertrude Nalubwama, the aunt of 11-year-old Ibrahim Nkangi
Nkangi was accidentally hit in the eye when he was young. His eyes became teary and would sometimes ooze blood. After an operation, he instead developed squints.
His eye still hurts him and sometimes gets teary. He cannot clearly see things written on the blackboard. Doctors at Mulago Hospital suggested surgery. He is now waiting to undergo surgery.
BRENDA Akello had a normal delivery. The mid-wife carefully examined the baby to ensure its body parts were fully developed. However, three months later, Akello noticed something odd about her baby’s eyes.
“Whenever I would pass an object in front of the baby, her eyes would roll in different directions. When I took the baby to hospital, I was told she had squints and would require an operation to correct them,†Akello narrates.
Dr. Grace Ssali, a paediatric eye surgeon at Mulago Hospital, describes squints as misalignment of the eyes or a condition where both eyes look at different points.
“The eye has six muscles responsible for controlling movement. When the muscles are uncoordinated, the eyes become misaligned,†Ssali explains.
She says squints can either be convergent (esotropia) or divergent (exotropia).
“A child with squints has double vision because each eye forms a different image. As a result, a child uses one eye, making the other eye lazy (amblyopia). If not treated before the age of nine, visual impairment becomes permanent,†Dr. Ssali warns.
According to Mulago Eye Department, about 10 to 12 cases of children with squints are registered every month, while Mengo Hospital registers about two to three squint cases in a month.
The challenge in managing squints in children is that most parents do not seek urgent medical help because of the misconception that squints correct themselves as the child grows.
But with early diagnosis and treatment, Dr. Cillasy Ruy Tumwesigye, a consultant Ophthalmologist at Mulago Eye Department, says squints can be corrected.
The child may also be saved from retinoblastoma (eye cancer). Correcting squints also boosts a child’s self-esteem and saves him from bullying from peers.
Cause and diagnosis
Dr. Ssali says a baby can be born with squints, or they can occur later in life from the age of three months.
Dr Rose Mutumba, an ophthalmologist at Mengo Hospital, says the cause of squints is unknown. She, however, notes that squints are common in children with other health challenges like those born prematurely, children with muscle control problems or any problem causing poor vision (short or long sight), problems with the brain, nerve disorders, traumatic brain injury at birth and children with cerebral palsy.
Other factors include hemangioma (a patch close to the eye or sometimes deeper), tumours in the brain or eye, retinoblastoma and cataracts.
“The eye specialist (ophthalmologist) will watch how the child looks around a room and then ask him or her to look at a source of light to find out if the light’s reflection is in the same position on each eye. Finally, the ophthalmologist covers one eye and watches how the uncovered eye moves, then uncovers it and watches how both eyes move,†explains Dr. Mutumba.
She adds that if the child is old enough, he or she will complain of not seeing well, having double vision or being sensitive to light. Besides, the examination of the retina is also done to identify any causes of squints, she explains.
How are squints treated?
Treatment of squints depends on the cause. Tumwesigye explains that glasses help to correct any refractive error.
He says for children who develop a lazy eye, ‘we patch one eye to strengthen the weak eye so as to regain vision’
Dr. Tumwesigye adds that if these methods do not correct the squint, an operation is considered.
Is surgery for squints available?
Dr Ssali says surgery for squints is offered free in hospitals like Mulago at the eye clinic in ward 1 A and Mengo Hospital. Alternatively, glasses are offered at a subsidised cost.
The operation is carried out under a general anaesthesia and takes about an hour. The eye surgeon works on the muscles connected to the eye so that they are either strengthened or weakened. The number of muscles moved depends on the type of squint. The child is able to see the next day after surgery.
Dr. Mutumba recommends that babies’ eyes be checked soon after birth and at intervals throughout childhood.
How I found out my baby had squints: Our readers had this to say...
Shamim Nambejja, the mother of six-month-old Shabirah Nagawa
Nagawa fell sick two days after birth. She developed a fever and started convulsing. She got squint eyes since then. When she turned three months, I took her to Mulago Hospital, but I was advised to take her back at six months for an operation. She has now been operated upon.
Agnes Namitala, the mother of one-year-old Martha Nanyonga
My family does not have a history of squints, but I noticed Nanyonga had the condition when she was about three months old. Whenever I put an object before her, her eyes would not follow it. When I took her to Mulago Hospital, she was started on treatment, but she did not respond. I was advised to wait until she turned one year so that the squints could be corrected by surgery.
Gertrude Nalubwama, the aunt of 11-year-old Ibrahim Nkangi
Nkangi was accidentally hit in the eye when he was young. His eyes became teary and would sometimes ooze blood. After an operation, he instead developed squints.
His eye still hurts him and sometimes gets teary. He cannot clearly see things written on the blackboard. Doctors at Mulago Hospital suggested surgery. He is now waiting to undergo surgery.