Squint & Paediatric Ophthalmology

Squint & Paediatric Ophthalmology

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Paediatric eye surgeries are used to treat a variety of eye problems. Squint (also known as strabismus) is a condition that arises because of an incorrect balance of the muscles that move the eye or faulty nerve signals to the eye muscles and focusing faults. If these are out of balance, the eye may converge (turn towards the inside), diverge (turn towards the outside) or sometimes turn up or down, preventing the eyes from working functioning together.

Squint can occur to anyone at any point in time irrespective of age or gender. In most cases, a baby can be born with a squint or develop one soon after birth. Around five to eight percent of children are affected by a squint or a squint-related condition, which means one or two in every group of 30 children.

Common squint related errors are

Refractive errors:

Parents have a major role to play in noticing any medical problem and getting the right help for their child or any other family member on time. Children are unable to explain their visibility issues, so eye examination in children is always recommended by doctors at an early age such as three. If parents suspect something wrong with their child’s eye, then it should be done even earlier.

Refractive errors can be corrected by glasses, but it needs detailed eye examination by putting dilating drops which makes the pupil large and relaxes the focusing muscles of the eye. large pupil helps to examine the interior of the eye easily. It relaxes the focusing muscles of the eye and allows for a more accurate determination of refractive error. Squint eye may be present since birth or result from injury. The treatment involves surgical procedures but most of them are treated conservatively.

There are several causes of double vision and squint in adults as well. These are managed by exercise, special glasses, and eye muscle surgery when required.

Strabismus or squint can also begin in adulthood due to medical problems, such as:

  • Thyroid disease;
  • Myasthenia gravis;
  • A brain tumour;
  • Head trauma;
  • Strokes.

Misalignment of the eyes may occur after surgeries such as cataract surgery or retinal surgery. This is due to damage to the eye muscles during surgery which is rare.

A person with any of the following needs to have a complete eye examination

  • Poor performance at school or at work
  • Viewing objects at a very close distance
  • Squint
  • Eyes shaking

The family history of eye problems or wearing glasses in children. Effect of dilating eye drops can last from 4 to 48 hours, depending upon the strength of the drop and upon the individual patient.

Preparations to be done before the operation

If the patient has a cold or infection before the operation, the doctor might postpone the surgery until the patient has fully recovered.

Squint correction is usually a one-day procedure done under general anaesthesia. The patient will be asleep during the procedure also he or she must not eat anything or drink milk for about six hours beforehand. Water can be drunk until two hours before the procedure. A nurse will measure your patient’s heart rate and blood pressure and inquire about his or her general health. In case of a child, their parent must tell the nurse if their child has any

allergies or if there is any history of bleeding problems in the family. The surgeon and anaesthetist will also visit the child before the operation.

About the procedure

The surgery performed will depend on the type of squint a patient has. The surgeon will make small cuts a few millimetres from the cornea (the clear structure at the front of the eye) and assess the muscles around the eye. This surgery is done to improve the position of one eye to match with the other.

Squint & paediatric surgery is as any other eye operation. It involves tightening and moving of the outside eye muscles which helps the eye change position.  These muscles are attached closely to the front of the eye under the conjunctiva. The eye is treated without taking it out of the socket during surgery. Stitches are used to attach the muscles to their new positions.

Squint surgery is a one-day procedure, so the patient is in and out of the hospital on the same day. There are two kinds of squint operation – adjustable and non-adjustable. In adjustable surgery, which can be performed in older children and adults, the stitches can be adjusted shortly after the surgery, when the patient is awake.

Risks from surgery are rare, but there can be unpredictability in the exact position of the eyes after surgery and sometimes more than one operation will be needed.

Occasionally, squints corrected during childhood reappear in adulthood. The muscles are then adjusted to correct the squint. If the muscle is too tight, it is detached from the eye and moved further back.

Post or After operation procedures

The patient is monitored for a short while and then brought back to the ward to recover. He or she may be sleepy and feel or be sick. He or she will need to rest until the effects of the general anaesthetic have passed.

Whenever the patient feels ready, he or she can begin to drink and eat, starting with clear fluids.

The patient will be asked to put special packs, soaked in icy water, on the eyes. They will have to continue doing this for up to 36 hours post-surgery.

Recovering from the operation

The patient’s eyes will be red and he or she may have some bruising around the eyes. This will last for about two weeks. You may notice that the eyes are not in perfect alignment immediately after the operation because the eye muscles are swollen. This will settle down after a few weeks.

The patient should carry on wearing their prescription glasses and follow any advice that the surgeon gives. The stitches will dissolve by themselves within approximately one to two weeks. Before they dissolve they may irritate and be uncomfortable for the first 24 hours after the operation and recover soon if all instructions are followed.

Why choose currae Hospital?

Receive treatment from best in class eye experts at Currae Eye Speciality Hospital that is guaranteed to speed healing. Experience a vast and ever-expanding array of amenities at NABH accredited infrastructure with post-operative care.

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