A squint eye, also known as strabismus, is a condition where the eyes do not align properly and point in different directions. For example, one eye may look straight ahead, while the other eye may turn inwards, outwards, upwards, or downwards. This can affect your ability to see clearly and perceive depth.

Normally, the eyes work together to focus on the same point at the same time, with the help of the extra ocular muscles that control the eye movements and eyelids. However, sometimes these muscles do not coordinate well, or there is a problem in the nervous system that affects the eye coordination. This can cause a squint eye to develop.

How Common is a Squint Eye?

A squint eye is quite common in India, affecting about 4% to 6% of the general population. However, premature babies have a much higher chance of developing a squint eye, with a rate of 30% to 40%.

What are the Risk Factors for a Squint Eye?

Some people are more likely to develop a squint eye than others, due to various factors, such as:

• Having a stroke, Down syndrome, or cerebral palsy.
• Having hyperopia or far-sightedness, which makes the eyes strain more to see clearly
• Having a family history of squint eye.
• Having poor vision in one eye.
• Having hydrocephalus, a condition where excess fluid builds up in the brain.
• Having brain tumours, head injuries, neurological problems, or Graves’ disease, which can affect the brain, nerves, or muscles that control the eye movements.

Types of Squint

There are different types of squint eye (strabismus), and they are categorized on the base of their direction and eye misalignment.

• Esotropia (crossed eyes) :- This type is most common in infants, in which one eye turns inward towards the nose, while the other remains straight.
• Exotropia (divergent or wall-eyes):- One eye turns outward, away from the nose, and the other remains straight. This can be an intermittent or constant phenomenon.
• Hypotropia (Vertical Misalignment):- Opposite to hypertropia, it is that form that results in the turning of one eye lower than the other eye. The lower eye will be facing downward while the upper eye remains straight.
• Hypertropia (Vertical Misalignment):- Hypertropia occurs when one of the eyes stands higher than the other. The higher eye may be turned upward while the lower eye remains straight.
• Consecutive Squint:- Consecutive squint occurs when one eye develops a squint after the other eye has been treated for squint.
• Alternating strabismus:- In alternating strabismus, either eye may turn, sometimes the left and other times the right.

Symptoms of Squint

The signs and symptoms of squint eye (strabismus) can vary depending on the type and severity of the condition. Here are some common signs and symptoms:

• Misaligned Eyes: One eye may turn inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia) compared to the other eye.
• Squinting or Closing One Eye: Some people may squint or close one eye to see more clearly or reduce double vision.
• Double Vision: Seeing two images of the same object, especially when the squinting eye is used.
• Head Tilt or Turn: To compensate for the misalignment of the eyes, some individuals may tilt or turn their heads in a specific direction.
• Poor Depth Perception: Difficulty judging distances accurately.
• Eye Fatigue or Strain: Straining or discomfort in the eyes, especially after prolonged use or focusing.
• Eyes Not Working Together: Inability of both eyes to simultaneously focus on the same object.
• Vision Issues: Blurred vision in one eye, particularly when the squinting eye is used.
• Cosmetic Appearance: The misalignment of the eyes may also be noticeable from a cosmetic standpoint, especially in severe cases.
• Difficulty with Activities Requiring Visual Coordination: Problems with tasks that require both eyes to work together, such as reading, driving, or playing sports.

Treatments for Squint Eye

Squint Eye Treatment

The squint eye treatment is based on what type of strabismus it is, its severity, the cause, the age of the patient, and also if there is the presence of other related conditions like amblyopia, otherwise mentioned as lazy eye

• Refractive Errors Correction: Strabismus of the developmental type can be treated using glasses or contact lenses if the refractive errors contribute to the problem.
• Patch Therapy: In cases of amblyopia, patching of the stronger eye will be done so that the weaker eye develops better vision.
• Eye Exercises Vision Therapy: In some cases, eye exercises or vision therapy will be recommended to improve the coordination of the eyes and strengthen the eye muscles.
• Botulinum Toxin Injection: Injections of botulinum toxin—Botox—are also applied with strabismus, especially in overacting muscles, to weaken particular muscles temporarily and improve the alignment of the eyes.
• Prism Lenses: Prism lenses are sometimes given to help align the eyes and eliminate double vision for some individuals receiving strabismus.
• Surgery: Squint eye surgery is necessary to surgically align the eyes by adjusting the length or position of eye muscles. Surgery usually has to be performed when other treatments have not been very successful or in case a gross deviation is hurting vision or appearance.