It’s normal for a newborn’s eyes to wander or cross occasionally during the first few months of life. But by the time a baby is 4 to 6 months old, the eyes usually straighten out. Kids tend to squint their eyes when focusing on a close object or when walking in sunlight, which is completely normal. Some adults are able to squint their eyes towards the nose to make a funny face. It is perfectly normal for kids and adults to consciously squint their eyes, but when this happens subconsciously and almost constantly, it could be Strabismus.
Strabismus is a medical condition where both of our eyes are unable to align and move in tandem, commonly known as squint eyes. In most cases, only one of the eyes lacks movement and focus to different degrees. However, this condition can affect both eyes and requires professional squint eye treatment to improve its symptoms like double vision, blurry vision, eyestrain, etc.
Our eyes and eyelids are moved synchronously by the extraocular muscles which are linked to the brain. These muscles respond to the neural signals from the brain to focus both eyes on an object. But when a genetic condition or an external factor damages this neural system, it prevents the extraocular muscles from controlling the eye movements, leading to misalignment in the eyeballs. Ultimately, while one eye may be able to focus on an object, the other eye may turn inwards, outwards, upwards, or downwards.
A squint causes the brain to reduce the use of the squinted eye and increase the use of the healthier ones. If left untreated during the growing age, the lesser-used eye starts to deviate further from the healthy eye and may become lazy. Lazy eye or Amblyopia is when the brain ignores the signals coming from the weak eye causing vision problems, such as double vision, poor depth perception, or in this case, a squint. This misalignment may be permanent or may appear on occasion.
Squinting can develop in various ways depending on the cause in children and adults. Typically, a squint can either be ‘constant’ where an eye permanently appears deviated, or it can be ‘intermittent’ where an eye sporadically deviates and squints from time to time. To prescribe the right squint eye treatment, an eye care professional may define a squint differently based on the following factors.
The most common classification of squints is based on the squinted eye’s direction:
Some squints may occur differently as you blink:
Squint classifications based on the movement of the afflicted eye:
Squints can also be classified by the degree of eye closure:
Some eye care professionals may choose to classify a squint based on the physical condition of the eyes:
A “Pseudo Squint” is when a wide gap between the eyes or a flat nasal bridge creates misalignment in the eyes which makes them look squinted.
Most squint eyes cases are a result of an abnormality in the neuromuscular control of the eyes. This abnormality can be caused by various congenital, hereditary, and acquired conditions. Causes can vary in adults and kids as discussed below
Strabismus may be present at birth or it may develop in the first 6 months after birth. Childhood illnesses can lead to squinting eyes, such as viral fever, measles, meningitis, etc. Neurodevelopment illnesses like Down syndrome or cerebral palsy can also cause a squint.
Hereditary factors play a major role in the development of squint after birth. Being a neuromuscular disorder, it can easily develop as the baby forms in the womb. In fact, the incidence rate of squint eyes in premature newborns is almost 30% to 40%. Such causes for a squint may include:
Having congenital refractive errors such as myopia (short-sightedness), hypermetropia (long-sightedness), or astigmatism, can also cause a squint in children if left untreated.
Adult squints are mostly caused by secondary factors such as trauma, brain lesions, excessive screen time, etc. It has been found to develop after a specific age in adults.
A head injury or nerve injury that involves the extraocular muscles often leads to a squint that resolves after the injury is treated.
One may develop a squint after suffering from a severe illness like glaucoma or a stroke. Other diseases that have been associated with squint eyes in adults include:
Squints may also be the result of a refractive error such as hyperopia or myopia.
Strabismus usually appears in infants and young children, most often by the time a child is 3 years old.
The sudden appearance of strabismus, especially with double vision, in an older child or adult could indicate a more serious neurologic disorder that may require additional care along with appropriate squint eye treatment.
Squint Symptoms in Kids
Typically, pediatric ophthalmologists are more apt in diagnosing squints in kids. Most eye care professionals use orthoptic tests for such evaluations in adults and children. But a typical diagnosis process includes the following procedures.
Any eye doctor first asks for a detailed medical history regarding eye conditions in the family and medications taken by the child of the parents. Eye movements are physically tracked by the eye specialist to check for crossed eyes or abnormal gaze.
Visual Acuity Test
Visual acuity grafts and charts are used to check the focusing power of the eyes and the difference in focusing ability in both eyes. It usually involves reading letters in decreasing size from an eye chart or similar viewing tests.
An eye specialist may also recommend refractive tests to diagnose optical problems that may be causing the squint. Refractive tests involve using a series of corrective lenses to measure the difference in their power and alignment. The Hirschberg test is another corneal reflex test where the doctor checks if light rays are properly refracted by both corneas.
Squint eyes can be assessed with an orthoptic test. The orthoptics test aims to establish the severity and type of squint eye, assess how well the child or adult can see, and test for binocular vision. It may also involve alignment and focusing tests after dilation (widening) of the pupils to determine the health of internal eye structures.
The right squint eye treatment options depend on the severity of the squint and other factors such as age, sex, and eye health. If left untreated, childhood squint can worsen over time, resulting in amblyopia, permanent visual impairment, or even blindness.
Each child requires an individualized treatment plan based on their symptoms and medical history. Eye doctors may start by prescribing a combination of the following treatments:
Corrective glasses are prescribed to treat refractive errors like hypermetropia and myopia, which cause the squint. The degree of squint and spectacle power needs to be examined and changed as the child grows up.
Eye patch is a traditional treatment method of squint eye treatment where the healthy eye of the child is to be covered for a fixed duration every day. This forces the brain to use the squinted eye and improve its visual performance. But the duration can extend depending on the child’s willingness to wear the patch punctually.
Eye exercises are fun activities for children to improve their visual focus and alignment. The most common exercises suggested by pediatric eye specialists include Pencil pushups, Brock String, and Barrel Cards.
When the noninvasive methods prove ineffective, ophthalmologists suggest surgically altering the extraocular muscles to improve the squinted eye’s alignment and movement. It is usually recommended for kids below 12 years of age.
While the eyes completely developed in adults, adult squints can be treated with non-surgical and surgical methods listed below:
Eye specialists can suggest personalized eye exercises to improve mild to moderate squints to some extent in adults who find it difficult to read or experience blurry vision after short periods of focused work.
These are specialized eyeglasses designed with prism lenses that refract light rays at specific angles before entering the cornea. They help reduce double vision and enable adults to perform routine activities like driving, reading, playing sports, etc.
Sometimes, surgery is the only choice to straighten the eye in adults. Squint eye surgery aims to loosen, tighten, or reposition the extraocular muscles to improve ocular alignment. Revisional surgery may be necessary to correct a residual squint that does not respond to wearing glasses.
Vision therapy software are scientifically-designed digital programs that aim to improve eye coordination. These are offered as games that stimulate both the eyes individually to improve their functionality, which can help reduce most of the symptoms in squint eyes.
Bynocs AmblyGo software, for example, is a simple and engaging eye treatment program designed to treat lazy eyes, which is often caused by squint eyes. The initial evaluation can be done at any eye clinic enrolled with Bynocs, and the treatment setup can be used at an eye clinic or in the comfort of your home with a stable internet connection. Such vision therapy software helps improve about 90% of visual symptoms, including that of squint eyes, in less than six weeks!
Vision therapy software is the most effective method to treat most visual impairment issues. You can get the latest Bynocs vision therapy software treatment at our partner eye clinics worldwide.