Strabismus is a vision disorder wherein there is problem with the alignment of the eyes and they point in different directions. It is a condition in which both eyes won’t align simultaneously under normal conditions. One or both of the eyes may turn in, out, up or down. One eye may seem to be looking in a straight direction, while the other eye turns inward, outward, upward, or downward. This could be consistently seen, or it may come and go and the eye that is straight may switch or alternate with the eye that is misaligned.
Strabismus in children does not go away without treatment and it is treatable in adults. Around 5 percent of all children show some type or degree of strabismus and they may initially have double vision due to the misalignment of the two eyes in relation to one another. In order to avoid double vision, the brain will eventually disregard or suppress the image of one eye.
Out of the many different types of strabismus, most commonly observed are exotropia, esotropia, hypotropia and hypertropia.
Strabismus can also be known by its cause. Weakness or paralysis of the 3 cranial nerves (III, IV, VI) responsible for eye movement can result in strabismus. Superior oblique palsy and third nerve palsy are some examples of paralytic strabismus.
Esotropia is inward turning of the eyes or having “crossed eyes”. Infantile esotropia, accommodative esotropia, and sixth nerve palsy are the types of esotropia. Exotropia is the outward turning of the eyes or having a “wall-eyed”.
Hypertropia and hypotropia is the vertical misalignment. Hypertropia is when the abnormal eye is higher than the normal eye, whereas, hypotropia is when the abnormal eye is lower than the normal eye.
Majority of strabismus is the outcome of an abnormality of the poorly understood neuromuscular control of eye movement and less commonly, a problem with the actual eye muscle causes strabismus.
Symptoms of strabismus include:
- Double vision
- Eyes that do not align in the same direction
- Eye movement that is not coordinated
- Loss of vision or depth perception
- Crossed eyes
These symptoms may be present throughout, or may appear intermittently.
The health care provider will do a detailed physical examination of the eyes to determine to what extent the eyes are misaligned:
- Corneal light reflex
- Cover/uncover test
- Retinal exam
- Standard ophthalmic exam
- Visual acuity
A brain and nervous system (neurological) exam will also be done.
The goal of strabismus treatment is to improve eye alignment which allows for the eyes to better work together. Treatment may involve eye exercises, prism, eye glasses and/ or eye muscle surgery. Problems associated with strabismus such as amblyopia, ptosis, and cataract are usually treated prior to eye muscle surgery.
Strabismus or squint treatment in India includes several options that improve eye alignment and coordination such as the following:
- Eyeglasses or contact lenses may be the only treatment needed for some patients.
- Prism lenses have a prescription for prism power in them. The prisms alter the light entering the eye and reduce how much turning the eye must do to view objects. Sometimes the prisms can eliminate the eye turning.
- Vision therapy helps improve eye coordination and eye focusing and trains the eyes and brain to work together more effectively. These eye exercises can help problems with eye movement, eye focusing and eye teaming and reinforce the eye-brain connection.
- Eye muscle surgery. Surgery can change the length or position of the muscles around the eye so they appear straight. Often, people who have eye muscle surgery will also need vision therapy to improve eye coordination and to keep the eyes from becoming misaligned again.
Squint is actually a symptom of an underlying cause which can be a dysfunction of the extra ocular muscles, or the nerves controlling them or amblyopia or in severe cases even Anisometropia. Sanjeevan provides strabismus or squint treatment without surgery that helps improve the co-ordination between the extra ocular muscles which in turn helps in proper binocular vision and improved depth perception. The co-ordination of the extra ocular muscles with our treatment also corrects Diplopia (double vision). This would also eventually avoid the brain to shut down the bad eye or lazy eye (Amblyopia). Our treatment helps in the conditioning of the nerves responsible for the extra ocular muscles and also the strengthening of the extra ocular muscles. The patients also see improvement in his/her vision during the course of the treatment.