Eye Doctors

Strabismus Surgery in Children

The most common children's eye conditions are strabismus (squint) and amblyopia (lazy eye), and both can be successfully treated. The earlier they are detected the better.

• What is a squint?
  A squint is a visual defect in which the eyes are misaligned, so they point in different directions. One eye may look straight ahead, while the other eye turns inward, outward, upward or downward. The eye turn may be constant, or it may come and go. In some cases, which eye is straight (and which is misaligned) may switch or alternate.
  
  
• What causes squints?
  The exact cause is not fully understood. Any factors influencing the brain's control of binocular vision, or the eye muscle functions can cause it. Occasionally squints can be associated with other conditions.
  
  
• What are the signs of squints?
  The main indication is that an eye is not straight. Sometime the child may turn or tilt their head to see better. Favouring one eye over the other can lead to amblyopia (lazy eye) and long term poor sight in that eye.
  
  
• What are the most common types of squints in children?
  Infantile (or congenital) esotropia - where the eye turns inward, is the most common type of squint in infants and it usually occurs between 3-6 months of age.
  
  Accommodative esotropia - is a common form of squint and often occurs in children two years of age, or older. The eye turns inward due to excessive focusing effort to give better vision. It can present when the child is looking at distant or near objects.
  
  Exotropia - refers to the outward turning of the eye. It can be constant or intermittent. Intermittent exotropia most often occurs when the child is looking at distant objects. It tends to become more noticeable when the child is tired or sick.
  
  
• How are squints treated in children?
  After a complete medical eye examination the child may be prescribed glasses. If glasses cannot control the squint, or are not needed then eye muscle surgery will be recommended to restore normal alignment and binocular vision (so the two eyes can work together).
  
  
• How is squint surgery performed on children?
  It is performed as a day stay procedure, under general anaesthetic. Our anaesthetists are experienced in children's anaesthesia and surgery is performed in a fully equipped private hospital.
  The eye muscle causing the eye to turn inward, or outward, are 'loosened', or 'tightened', as required. The eyes are not normally patched and recovery is fast so the child can resume normal activities within a few days.
  
  
• When should treatment start?
  Children suspected of a squint should be seen without delay by a specialist. No child to too young to be assessed and for treatment options to be discussed.
  
  
• What is pseudosotropia?
  The eyes of an infant may appear to be crossed, though they actually are not. This is often due to a wide, flat nose, or a fold of skin in the inner lids. Children may grow out the of pseudosotropia but they never grow out of a true squint.
  
  
• Strabismus Surgery Adjustable Suture Eye Muscle Surgery
  Nystagmus, or jiggling of the eyes, can occur from poor vision in childhood, or as a result of albinism (lack of pigmentation in the skin) and other neurological conditions. In these patients, turning their head to certain directions minimises the intensity of the jiggling of the eyes and their vision often improves. Eye Doctors offers special eye muscle surgery that can lead to straightened head posture, reduced jiggling of the eyes and improved vision.

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