Paediatric Strabismus

We still don’t know the exact cause of strabismus or misaligned eyes (also known as ‘squint’ or crossed eyes – often associated with a squeezing of the eyes) but in some cases it is due to excessive focusing power of the natural lens, which can be corrected by using prescription glasses. However, in other cases surgical intervention may be required.

You may ask why it’s important to have two aligned eyes – the answer is that our eyes should work and move together to give us the best visual function and strabismus can cause a number of vision issues; for example, you can develop a weak or lazy eye if one of them is not being used correctly due to the fact that the brain eventually stops using information from the misaligned eye, which results in it becoming weaker and weaker over time.

There are two main types of strabismus:

1. Convergent squint or esotropia
2. Divergent squint or exotropia

A person with strabismus has one eye that looks directly at an object while the other eye may be misaligned and look inward (esotropia) or outward (exotropia); the strabismus may be a permanent feature or happen only occasionally.

Childhood strabismus should be treated by a paediatric ophthalmologist as early as possible. There is a common misunderstanding that strabismus in childhood improves naturally as the child grows older but this is not correct.

In adults, eye alignment is not strictly a cosmetic surgery procedure (intended to enhance the appearance of a normal aging person); eye alignment surgery is considered to be a reconstructive procedure with many other benefits beyond restoring normal appearance, including:

1. Improved depth perception or binocular vision
2. Improved visual fields
3. Eliminating or minimising double vision
4. Improved social function for patients, with the greater personal confidence they enjoy following surgery

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