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Pediatric Ophthalmology and Squint Services

We also have comprehensive services in:

  • The management of squint, double vision and other disorders of eye alignment and movement, both in children and adults
  • The management of amblyopia or lazy eyes
  • Refraction in young children using eyedrops (cycloplegic refraction) for those who have difficulty getting a good refraction.
  • General eye problems such as eye sore, allergic conjunctivitis and lumps on the eyelids (stye and chalazion).
  • Providing pediatric ophthalmology consultation to doctors in the pediatric departments.

Pediatric ophthalmology is a sub-speciality of ophthalmology concerned with eye diseases, visual development, and vision care in children. Pediatric ophthalmologists are specially trained to manage the following disorders:

  • Infections (Conjunctivitis).
  • Strabismus or Squint is a misalignment of the eyes
  • Amblyopia or Lazy eye occurs when the vision of one eye is significantly better than the other eye and the brain begins to rely on better eye and ignore the weaker one.
  • Blocked tear ducts.
  • Ptosis- Drooping or falling of upper eye lid
  • Retinopathy of prematurity often seen in premature babies
  • Nystagmus
  • Visual inattention
  • Pediatric cataracts
  • Pediatric glaucoma
  • Abnormal vision development
  • Genetic disorders often cause eye problems for affected children.
  • Congenital malformations affecting vision or the tear drainage duct system
  • Orbital tumours
  • Refractive errors such as myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism can often be corrected with prescriptions for glasses or contacts.
  • Accommodative insufficiency
  • Convergence insufficiency and asthenopia
  • Evaluation of visual issues in education, including dyslexia and attention deficit disorder.

What is Squint?

Squint or strabismus is a misalignment of the eyes so that the eyes do not point in the same direction. Squint can itself lead to amblyopia or lazy eye. More importantly squint if present since childhood can itself lead to loss of three dimensional vision or depth perception (stereopsis). Many cases can be treated with glasses. Orthoptic exercises are useful in some cases. Prism trials can be used as a temporary or permanent measure. Squint can itself lead to cosmetic disfigurement, in addition in children there is a risk of amblyopia.

Under such circumstances, it is important that one corrects the squint early. In addition there is a beneficial effect of correction of squint even in older adults as there is improvement in binocular vision. The simplicity and ease of surgery means some patients start work the next day after surgery. The results are very good with a proper clinical assessment and surgery.

The most common types of squint

Esotropia (convergent squint) :

Convergent squint can be corrected many a times by glasses. Early correction is recommended especially in the convergent squints as there is a higher risk of amblyopia and loss of binocularity.

Exotropia (divergent) :

Divergent squint can again be corrected with glasses, but more commonly needs surgery.

Vertical squints are tackled especially in cases of superior oblique muscle palsy or Brown Syndrome and need proper planning, surgery is however easy to perform.

Nystagmus can also be considered as a form of squint and indications for surgery include head posture or need for dampening the nystagmus. Newer surgeries for this condition give successful outcomes.

What are the signs and symptoms of a squint (strabismus)?

  • 1 .  One of the eyes does not look straight ahead, but veers.
  • 2 .  Infants (newborns) may go cross-eyed, especially if they are tired. This does not mean they have a squint. Concerned parents should check with their doctor.
  • 3 .  If you notice that your child has one eye closed, or turns his/her head when looking at you, this could be a sign of double vision, and a squint is possible. Check with your doctor.
squint baby

What are the causes of a squint (strabismus)?

  • 1 .  Congenital or Heriditory. In the majority of cases, people are either born with strabismus or develop it during their first six months after birth.
  • 2 .  Due to some Refractive Errors [If the Child has a Spectacles] as the child may turn the affected eye inward in order to get a better focus.
  • 3 .  Associated Neurological Conditions [ Brain Disorders]
  • 4 .  Viral infections, such as Measles

What are the treatment options for a squint (strabismus)?

A diagnosed squint needs prompt treatment, otherwise there is a serious risk of complications, such as amblyopia (lazy eye). The younger the patient is, the more effective treatment is likely to be.

Glasses – if the child is found to hypermetropia (long-sightedness), they will be prescribed glasses which usually solve the squint.

Pediatric Ophthalmology

Eye patch – this is worn over the good eye to get other eye, the one with the squint, to work better.

eye patch

Orthoptic Exercises –The doctor may also prescribe eye drops, and get the patient to do specific eye exercises.

Botulinum toxin injection (Botulinum) – this is injected into a muscle on the surface the eye. The doctor may recommend this treatment if no underlying cause can be identified, and if signs and symptoms come on suddenly. The injected muscle is weakened temporarily, which often helps the eyes to align properly.

Surgey – surgery is only used when other treatments have not been effective.can restore binocular vision, as well as realign the eyes. The surgeon moves the muscle that connects to the eye to a new position – sometimes both eyes need to be operated on to get the right balance.

Squint Surgery

The simplicity and ease of surgery means some patients start work the next day after surgery.The results are very good with proper clinical assessment and surgery.