How To Tell If A 8Yr Old Boy Need Glasses Don’t Neglect Squint Eyes

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Don’t Neglect Squint Eyes

Squint eyes over the years have been looked upon as a black spot

on the human beauty. Nevertheless, it has been posing the

prospective brides with innumerable problems in matters of

matrimony. However of a beauty she might be, one look at her

eyes the boy turns her down. Such boys do not care to probe

whether squint eyes can be set right.

Sometimes, on the other hand, people with squint are considered

lucky in the society. But the Ophthalmologists who know the

consequences of squint, do not think so. On the contrary, they

stress the disadvantages and negative aspects of squints- as

outlined below.

The two eyes normally should be in a definite visual axis.

A manifest deviation of the visual axis of either eye is known

as squint or strabismus. So one eye is deviating or squinting,

the other eye takes up the visual function mainly. So it

becomes a dominate eye. Most of the time, the deviating eye

slowly becomes impaired functionally. Later it almost becomes

blind. This hard fact will not be known to the squinting person

unless he closes the good eye and tests for the other eye vision.

When the degree of squint is gross, it is very easy to recognise

that. But when there is a small amount of squint, various tests

have to be done to diagnose correctly the type and amount and

presence of squint.

Mainly there are two types of squint -paralytic and non-paralytic.

There are seven small muscles around each eye-ball, which are

responsible for the various movements of the eye. These muscles

are supplied by 3rd,4th, and 6th cranial nerves- which are derived

from the brain.

Whenever these nerves become weak or lose their conducting

capacity, the respective eye muscles become immobile. So when

the other normal eye moves in a particular direction, if the

affected eye cannot move in the same direction, squint becomes

evident which is a paralytic squint.

Non- paralytic or concomitant deviations are for the most part,

produced by anomalies of the power of convergence and divergence

and the co-ordinated use of the two eyes to obtain binocular

single vision. In these cases the amount and character of the

deviation does not vary when the eyes are turned to the right

or left.

Before going to the causes of squint, it is necessary to know

the necessity of two eyes. It is the fact that when we observe a

single object with both the eyes we see it as a single object

instead of two. Obviously one may ask -what is the necessity of

having two eyes? Even if one becomes blind, the other one can

function normally – one may think.

One eye is always complement to the other eye. When we see

with both eyes, the extent or field of vision is definitely wider

than with one eye. Moreover, two eyes are necessary to have

what we call as ” BINOCULAR SINGLE VISION” the important

aspect of this being depth perception. There are 3 stages in this

binocular single vision.

1. Simultaneous perception.

2. Fusion.

3. Steriopsis ( the one which gives the sense of depth )

The development of reflexes concerning the binocular single

vision and the movements of eye muscles – are not complete

until the child is 5 years. Usually this will be established

when the child becomes 8 years old. So any disturbances during

this period ( below 5years ) may hamper the relation between the

movement of the two eyes and may cause a squint.

Causes of Squint :

1. Accommodation and convergence anomalies.

2. Refractive errors.

3. Weakness in the nerves supplying the eye muscles.

4. The gross difference in the vision between 2 eyes

due to any reason.

5. Patching or closing of one eye for a prolonged period.

6. Defect in the development of the nerves between retina

and the brain.

7. Hereditary and genetic or familial causes.

Clinically, there are two types of squints – Convergent Squint-

when one or both eyes are turned in, and Divergent Squint –

when one eye is turned outside the normal visual axis.

Treatment :

No case of squint can be said to be ‘cured’ unless, in addition

to normality of appearance, there is restoration of binocular

single vision in all circumstances. Although the latter cannot

be achieved in every case, a satisfactory cosmetic result can

invariably be obtained by means of operation or surgery.

In a case of squint there may be three possible defects of

function which have to be remedied:

1. The loss of normal function of the squinting eye. This

may not only concerns visual acuity but also visual

localisation.

2. The loss of normal binocular function.

3. The physical deformity caused by the deviation of the

visual axis. This is the defect which attracts the attention of

parents but is the least important from the point of view

of visual function.

To give complete treatment, child should be between 6 and

8 years. So the parents and school teachers have a very

important role to play. They should subject these squinting

children for treatment at the earliest. Because any treatment

or surgical correction done after the age of 8 years is not

complete or perfect because then we can only correct the

physical deformity but we cannot get the very important

functional part of it i.e. binocular single vision. So most of

the time in persons who are treated for squint after the age

of 8 years, one eye would be stronger, other eye would be

weaker. They will not have binocular single vision – which

can give them the exact form and depth perception.

The methods of treatment:

1. Correcting the refractive errors – by glasses whenever

refractive error is found to be the cause of squint.

2. Deliberate occlusion or patching of the fixing eye so as

to improve the vision of the squinting eye.

3. By special type of (orthoptic ) exercises in order to

improve the binocular faculties.

4. By operation or surgery – to restore parallelism of the

visual axis.

One or more of these methods or all four may be needed in any individual

case.

Finally it is the dire responsibility of the parents and the

teachers to detect this malady, which renders their children

look ugly in the eyes, during the tender age of 6 to 8 years

lest it is practically impossible to develop a squintless society.

— Dr.H.S.Mohan

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