Squints can be corrected
SOME people call it cross-eyes, but doctors say a squint should not be ignored. In medical terms, a squint is known as strabismus. It is a misalignment of the eyes such that they do not look in the same direction.
By Carol Natukunda
SOME people call it cross-eyes, but doctors say a squint should not be ignored. In medical terms, a squint is known as strabismus. It is a misalignment of the eyes such that they do not look in the same direction.
This may be constant, occasional and sometimes the eyes may be straight. It is a common condition among children, although it may also occur in adults.
Dr. Ada Kakembo, the assistant secretary general Opthamological Society of East Africa, Uganda Chapter, describes a squint as a situation where both eyes are not in coordination. “If there is an object of attention in front of you, one eye looks at it, while the other does not,†she says.
Who is susceptible?
Kakembo says everyone is at risk of getting a squint. In children, it can result from stretching of the six eye muscles. “There are muscles attached to each eye ball to control the movement of the eye. Each of them acts alongside its counterpart in the other eye to keep both eyes aligned,†Kakembo explains. “But if the muscles, say on the right corner of your eye, get stretched towards the ear, a squint occurs because it cannot keep in shape with the other eye, whose muscles were not stretched.â€
Dr. Denis Sekubwa, an ophthalmologist, says a squint can also occur due to a refractive error — long-sightedness or short sightedness. “When a child needs glasses and you ignore the condition, the child stretches the eyes in an effort to see clearly. So a squint will result,†Sekubwa argues.
Dr. John Ariganyira, an eye doctor at Medical and Eye Clinic Centre, Makindye, adds that a squint can also be a symptom of an underlying disease in the eyes. “It can be a cancer or a growth called Retinoblastoma (when something white floats in your eye).â€
Kakembo says a squint can also be hereditary. “If someone in the family had a cataract (clouding of the eye’s lens), the baby could also get it. Some people say it is curable.â€
According to Kakembo, in adults, a paralysis, especially after an accident, can make someone’s eyes squinted. “The muscles in our eyes have nerves leading to the brain. Should blood clot on the nerves, the muscles cannot work,†she says.
Sekubwa adds that diabetes, hypertension or increased pressure in the head, can also spark off a squint. Allrefer, a medical website, reveals that sometimes long sight may lead to inward deviation of the eye. Poor vision in the eye because of diseases like a cataract, may also cause the eyes to deviate. It is important to have an eye check-up to rule out other causes of loss of vision.
Dangers of a squint
Many doctors say squints can develop into a process called amblyopia (dimness of sight, without apparent organic defect) for children, or double vision for adults. “Each of the eyes sends a picture of the same object to the brain. When the images reach the brain, they create a lot of confusion, which can result into a constant headache,†Ariganyira says.
Kakembo says: “The retina and brain grow together. But if you do not correct the squint, the development of the two organs gets retarded. In case it extends to the optic nerve, it can result into blindness or even death.â€
Can a squint be detected early?
In his 2005 article on BBC health, Dr. Rob Hicks, an American health expert, said the eyes of a newborn are rarely aligned at birth.
“Most eyes establish alignment at three to four weeks. Some squints are common in babies up to two to four months, although usually, they are intermittent. Therefore, any squint in a child more than one month old must be taken seriously and should be evaluated by an ophthalmologist.â€
“Persistent squints after this age need to be investigated. Some squints are obvious with the eyes clearly looking in different directions, but minor squints may be difficult to see. Other symptoms may include blurred vision,†Hicks explains.
Eye specialists also recommend that anything white that floats on the eye should be treated as an emergency.
Treatment for a squint
An ophthalmologist, who does a few tests to find out the cause and quantifies the amount of deviation, diagnoses the squint. In some cases, there may be a false appearance of a squint due to a broad nasal bridge in a child. An ophthalmologist can differentiate between a true squint and a false one.
Sekubwa says a squint can be corrected for a child below nine years. The correction can be done in several ways.
“If one eye becomes ‘lazy’ or defected, the good eye can be covered, so that the ‘lazy’ one adjusts to the right vision,†he explains.
Ariganyira adds that the eye should be patched until the underlying cause is established. “Glasses with a prism are recommended if it is a refractive error and they can correct the squint.â€
AllRefer reveals that squint treatment should aim at preserving vision, straightening the eyes and restoring binocular vision. The eyes are checked to see if they have a refractive error, which causes a squint. If the refractive error is detected, it is treated first. In some cases, a correction of the error treats squints.
Next, the eyes are checked for presence of amblyopia. It is important to treat amblyopia before the surgery for squints. Parents are educated about the importance of this treatment, as their cooperation is crucial for the success.
A squint is treated by surgery of either one or both eyes. The surgery involves weakening or strengthening of the relevant muscles to restore the balance and get a good coordination. In some double vision cases, prisms may be added in the glasses to ease the symptoms.
Kakembo says surgery is only necessary when the muscles are over stretched and in case of an injury or a cataract.
“The surgeon removes the clouded lens in the eye and in most cases, replaces it with a clear plastic lens,†he adds.
But if the illness is not grave, doctors can use a temporary paralytic eye drop or drugs. Eye surgeries, including correction of a squint, can be done at Mulago and Mengo hospitals. A health worker at Old Mulago Hospital Eye Clinic says correcting a squint may cost between sh50,000 and sh90,000, if it involves an operation. But treatment is free.
SOME people call it cross-eyes, but doctors say a squint should not be ignored. In medical terms, a squint is known as strabismus. It is a misalignment of the eyes such that they do not look in the same direction.
This may be constant, occasional and sometimes the eyes may be straight. It is a common condition among children, although it may also occur in adults.
Dr. Ada Kakembo, the assistant secretary general Opthamological Society of East Africa, Uganda Chapter, describes a squint as a situation where both eyes are not in coordination. “If there is an object of attention in front of you, one eye looks at it, while the other does not,†she says.
Who is susceptible?
Kakembo says everyone is at risk of getting a squint. In children, it can result from stretching of the six eye muscles. “There are muscles attached to each eye ball to control the movement of the eye. Each of them acts alongside its counterpart in the other eye to keep both eyes aligned,†Kakembo explains. “But if the muscles, say on the right corner of your eye, get stretched towards the ear, a squint occurs because it cannot keep in shape with the other eye, whose muscles were not stretched.â€
Dr. Denis Sekubwa, an ophthalmologist, says a squint can also occur due to a refractive error — long-sightedness or short sightedness. “When a child needs glasses and you ignore the condition, the child stretches the eyes in an effort to see clearly. So a squint will result,†Sekubwa argues.
Dr. John Ariganyira, an eye doctor at Medical and Eye Clinic Centre, Makindye, adds that a squint can also be a symptom of an underlying disease in the eyes. “It can be a cancer or a growth called Retinoblastoma (when something white floats in your eye).â€
Kakembo says a squint can also be hereditary. “If someone in the family had a cataract (clouding of the eye’s lens), the baby could also get it. Some people say it is curable.â€
According to Kakembo, in adults, a paralysis, especially after an accident, can make someone’s eyes squinted. “The muscles in our eyes have nerves leading to the brain. Should blood clot on the nerves, the muscles cannot work,†she says.
Sekubwa adds that diabetes, hypertension or increased pressure in the head, can also spark off a squint. Allrefer, a medical website, reveals that sometimes long sight may lead to inward deviation of the eye. Poor vision in the eye because of diseases like a cataract, may also cause the eyes to deviate. It is important to have an eye check-up to rule out other causes of loss of vision.
Dangers of a squint
Many doctors say squints can develop into a process called amblyopia (dimness of sight, without apparent organic defect) for children, or double vision for adults. “Each of the eyes sends a picture of the same object to the brain. When the images reach the brain, they create a lot of confusion, which can result into a constant headache,†Ariganyira says.
Kakembo says: “The retina and brain grow together. But if you do not correct the squint, the development of the two organs gets retarded. In case it extends to the optic nerve, it can result into blindness or even death.â€
Can a squint be detected early?
In his 2005 article on BBC health, Dr. Rob Hicks, an American health expert, said the eyes of a newborn are rarely aligned at birth.
“Most eyes establish alignment at three to four weeks. Some squints are common in babies up to two to four months, although usually, they are intermittent. Therefore, any squint in a child more than one month old must be taken seriously and should be evaluated by an ophthalmologist.â€
“Persistent squints after this age need to be investigated. Some squints are obvious with the eyes clearly looking in different directions, but minor squints may be difficult to see. Other symptoms may include blurred vision,†Hicks explains.
Eye specialists also recommend that anything white that floats on the eye should be treated as an emergency.
Treatment for a squint
An ophthalmologist, who does a few tests to find out the cause and quantifies the amount of deviation, diagnoses the squint. In some cases, there may be a false appearance of a squint due to a broad nasal bridge in a child. An ophthalmologist can differentiate between a true squint and a false one.
Sekubwa says a squint can be corrected for a child below nine years. The correction can be done in several ways.
“If one eye becomes ‘lazy’ or defected, the good eye can be covered, so that the ‘lazy’ one adjusts to the right vision,†he explains.
Ariganyira adds that the eye should be patched until the underlying cause is established. “Glasses with a prism are recommended if it is a refractive error and they can correct the squint.â€
AllRefer reveals that squint treatment should aim at preserving vision, straightening the eyes and restoring binocular vision. The eyes are checked to see if they have a refractive error, which causes a squint. If the refractive error is detected, it is treated first. In some cases, a correction of the error treats squints.
Next, the eyes are checked for presence of amblyopia. It is important to treat amblyopia before the surgery for squints. Parents are educated about the importance of this treatment, as their cooperation is crucial for the success.
A squint is treated by surgery of either one or both eyes. The surgery involves weakening or strengthening of the relevant muscles to restore the balance and get a good coordination. In some double vision cases, prisms may be added in the glasses to ease the symptoms.
Kakembo says surgery is only necessary when the muscles are over stretched and in case of an injury or a cataract.
“The surgeon removes the clouded lens in the eye and in most cases, replaces it with a clear plastic lens,†he adds.
But if the illness is not grave, doctors can use a temporary paralytic eye drop or drugs. Eye surgeries, including correction of a squint, can be done at Mulago and Mengo hospitals. A health worker at Old Mulago Hospital Eye Clinic says correcting a squint may cost between sh50,000 and sh90,000, if it involves an operation. But treatment is free.