What Is Squint (Strabismus) and How Is It Treated in Children?

Squint or strabismus is a condition where one or both eyes are misaligned. This condition, often referred to as squint eye in children, affects the ability to see in stereo and judge distances, and may lead to significant social and adaptive challenges. Misaligned vision can cause severe psychological discomfort to children who are often bullied at school, increasing the risk of long-lasting vision problems such as amblyopia. 

Many parents, however, ask the question, “can squint eyes be corrected?” The answer to this question is affirmative because if treatment is started early, squint eye treatment can yield very positive outcomes. Most cases of strabismus are manageable with proper diagnosis and treatment based on the expertise of qualified pediatric ophthalmologists like Dr. Digvijay Singh, a distinguished graduate from AIIMS and author of numerous publications, who believes children as young as two years can be effectively treated with timely intervention.

What Is a Squint Eye?

So, squint eye is defined as a form of eye misalignment whereby both eyes are unable to fixate at the same target simultaneously. There is a possibility of one eye turning either inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia) while the other eye remains focused. Whether stable or intermittent, this form of misalignment is usually associated with a persistent eye turn as well as head tilt.

What Are The Causes Of Squinted Eyes?

Dr. Digvijay Singh explained how understanding what are the causes of squinted eyes is important for developing effective treatments. 

The causes of squint eye are reported as:

Refractive errors

A common form of inward eye deviation is esotropia, which is caused by hyperopia (farsightedness). Children compel themselves to see better, which results in one eye crossing.

Muscle its imbalance or nerve palsy

An imbalance in strength or nerve supply to the muscles of the eye can distort alignment. For example, there is an effect of lateral rectus muscle due to abducting nerve palsy.

Prematurity and low birth weight

Inadequate strabismus control may be due to poorly developed coordination of eye movements.

Neurological or genetic condition disorders

Some chromosomal anomalies such as Down syndrome, as well as certain 'neuro' disorders disrupt aligning of the eyes.

Sensory Deprivation

Vision disorders such as cataracts or ptosis can result in squinting by preventing sight from developing normally.

Often, particularly in the case of early onset squint, no specific reason can be identified.

Early Indicators and Symptoms

Do monitor for early signs and symptoms of squint eye in children, which include:

• Misalignment of the eyes
• Head squinting or tilting to aid focus
• Closing one eye in bright environments
• Temporary eye crossing
• Acknowledged late in infancy—physiological misalignment by 3–4 months is often noted.

Ideally, this is identified before six months, which allows for interventions that optimize outcomes. The persistent squint beyond four months along with eye closing, lack of depth perception, or head tilting are concerning.

Identifying Squint Eye

Analysis by pediatric ophthalmologists, for instance, Dr. Singh includes:

• Behavioral observation for clear misalignment
• Cover test eye movement confirmation
• Refraction tests to identify refractive errors
• Primary evaluation includes corneal light reflex, comprehensive ocular motility assessment, and fundus examination

Tests can reveal conditions such as pseudo squint. Babies with flat faces may be misdiagnosed, and cover tests are instrumental in confirming the diagnosis.

Treatments for Squint Eyes

Can squint eyes be corrected? Yes indeed. Treatment for squint eyes is comprehensive:

1. Treatment through glasses: ​In cases of hyperopia induced esotropia, providing full hyperopic correction usually results in ocular straightening.

2. Patching or blur treatment: Strengthening the patching amblyopia blurred patching patch improves the weaker eye during alignment correction phase.

3. Vision therapy & exercises: Guided pencil push-ups and computer training improve eye coordination.

5. Botox treatment: Botulinum toxin injected into the eye muscles of the stronger eye temporarily non-surgically aids ocular alignment by weakening those muscles.
6. Surgical correction: Alignment is restored by reshaping eye muscles which is done frequently and with great success under anesthesia. Dr. Singh has performed advanced squint surgeries such as split rectus transpositions on complex cases with wonderful results.

Corrective Steps by Age and Category

• For infants diagnosed with disorders like Infantile esotropia or exotropia under the age of 6 months usually require surgical intervention as the first option, often in combination with glasses.
• Children older than 2 years may require glasses along with vision therapy, administered intermittently with patching treatment before surgical options are considered.
• Esotropia with small angle deviations or early onset types can benefit from Botox therapy if binocular vision is present.
• For constant large angle deviations in vision or persistent cases that do not respond well to conservative techniques Botox is also indicated.

What to Expect from Treatment

• Glasses: Effective for managing refractive squint conditions; compliance is critical, especially with children.
• Vision therapy: Requires considerable diligence, but fosters improved coordination.
• Botox: Safe with mild side effects (damage to skin or muscles that will heal) and temporary effects.
• Surgery: Provides Dr Singh with the highest rates of success. Tailored muscle repositioning for gaze palsy and many of his other pediatric cases permit alignment recovery in the postoperative period.

With some balance between both strategies, patients can help themselves with covered alignment resulting in recurrent glasses or in some cases, additional procedures to fine-tune balance postoperatively to correct residual eye turn.

Long-Term Outlook and Follow-Up

 Post alignment, a fair number of children would still require proactive management for:

• visual acuity monitoring, depth perception and stereopsis assessment/monitoring.
• reduction through patching or therapy (managed “amblyopia”).
• absence of lie/turn recurrence (“recurvature”).
• change (dynamic refractive correction) “glasses” appropriate to developmental changes of the eyes.

Comprehensive approaches can result in many children improving eye alignment and achieving normal vision.

Role of Dr. Digvijay Singh

Strabismus as well as neuro-ophthalmology pediatrics are Dr. Digvijay Singh's specialties at Noble Eye Care Gurgaon. His experience from AIIMS and training widens the selection spectrum for squint eye treatment, particularly in children. Patients who undergo squint surgery with Dr. Singh attest to having improved straight alignment afterwards, solidifying the fact that their previously misaligned vision was successfully corrected.

Preventive Strategies for Parents

• Consistent screenings: Pediatrician appointments should include checking eye alignment until age 2.
• Monitor for early warning signs: Report misalignment, head tilting, or squinting as soon as possible.
• Corrective measures should be taken as early as possible: Glasses should be worn if prescribed.
• Adhere to therapy: Patched vision and exercises focusing on amblyopia are crucial to strengthen the affected eye.
• Referral without delay: Do not wait to see pediatric ophthalmologists like Dr Singh; care delays increase the chance of failed intervention.

Closing Remarks

 Childhood strabismus, or squint eyes, is an eye condition that is quite prevalent and is easily treatable. Knowing what is strabismus, identifying early symptoms, and devising a prompt, personalized treatment strategy, be it glasses, vision therapy, Botox, or surgery, can dramatically enhance the prognosis. With experts such as Dr. Digvijay Singh providing comprehensive care for pediatric squints, the answer to 'can squint eyes be corrected?' is an emphatic yes. Receiving timely care along with diagnosis and regular monitoring unlocks the possibility of clear, straight vision and a positive, confident future.

A proactive approach makes all the difference, so if you notice any concerns regarding your child’s eye alignment, don’t hesitate to reach out to a pediatric ophthalmologist. You have the opportunity to redefine a child’s visual journey, forever.