ASQUINT IS when a child’s eyes point in different directions. This is often something a child is born with and is evident from birth. Problems with eyesight can also lead to a squint particularly if your child is long-sighted — the eye turns inwards or outwards in an effort to focus properly. This type of squint can be noticed from around the age of two. A child is more at risk of a squint if they are born prematurely or have a family history of them.
Glasses are one of the most common treatments for squints and are used firstly to correct any vision problem. This can correct the squint. Botulinum toxin (Botox) has now started to be used on the NHS for squints: this is injected into the eye muscles and allows them to realign.
Surgery is used if other treatments are unsuccessful. The eye’s movements are controlled by a set of muscles and corrective surgery moves these muscles to a new position to straighten the eyes. This is done as day case surgery, under general anaesthetic and most children go home the same day. The eyes can be sore for a few days afterwards but recovery actually involves using the eyes, for exam- ple reading as soon as the patient feels comfortable, so the eyes get used to working again.
A second operation for further alignment of the eyes is not uncommon: around one in five go on to have a second operation.
People think patching is a treatment for squints but it isn’t. Patching is used for children with squints but is not a treatment. It is actually saving the child’s vision, but not affecting the cosmetic appearance. When a child has a squint, one eye becomes “lazy” — we call this amblyopia. This weaker eye is pointing in the wrong direction and so doesn’t get all the visual stimuli the other one does; an eye needs these stimuli to develop proper visual pathways to the brain. A lazy eye will not therefore have proper development and the child relies more and more on the good eye.
Patching is used to cover the good eye, which forces reliance on the weaker eye, and so it can start to develop proper visual pathways. The earlier this is done the better, and often starts from age two. If left untreated beyond seven years old, it is usually too late to acquire full vision in the lazy eye.
When a child has a squint, one eye becomes ‘lazy’