Achild­may­haveasquint

The Jewish Chronicle - - LIFE -

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’

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