Squinting
Strabismus (Latin name)By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute
Many infants squint but most grow out of it. Squinting can lead to reduced vision on one eye. This is why you should contact your doctor if the child is six months old and squints the whole time, or if the child is 4 years old and squints sometimes and your impression is that the child has poor eyesight.
Many infants – in fact as much as 15% - squint, but most grow out of it before they are 1 year old. Only 4 percent of these children squint when they are 4 years old. Many of them will have reduced vision on one eye (stereoblindness) if the squinting is not treated. If, later in life, the child has an accident or the other eye falls ill the child can become completely blind.
The movement of the eyes are controlled and coordinated by 6 muscles that ensure the directions of the eyes are the same. Eye muscle paralysis can be the cause of squinting, but only rarely. The most frequent cause is heredity. If squinting runs in the family, remember to check carefully if the child squints.
A child squints when its eyes do not look in the same direction. Heavy squinting is easy to detect. However, squinting may also be quite mild which can be hard for parents to detect. Some children squint all the time while some only squint sometimes, typically when the child is tired. When the child squints one eye is turned – it can be either inward, outward, upward or downward.
The different types of squinting cause the same problem, namely double vision (diplopia). Since the child finds double vision uncomfortable it will try to get writ of it – and this is possible! If the child stops using one eye the double vision goes away. However, if the child continues not using the eye its eyesight will suffer from it. This is called a lazy eye. If the eye is not rehabilitated in time, the child’s eyesight on that eye will be heavily reduced. This will lead to the child suffering from stereoblindness.
Your child’s eyesight will be examined in connection with the four-year children’s examination with the child’s general practitioner. If the doctor finds reduced vision or squinting your child will be referred to an ophthalmologist. A lazy eye with reduced vision must be rehabilitated. This is done by putting an eye patch over the good eye and thereby forcing the child to use the lazy eye. The ophthalmologist can also use eye drops in the good eye making its vision blurry and thereby rehabilitating the lazy eye.
You can rehabilitate a lazy eye all the way up to the age of 6. However, if the child is more than 7 years old it is rarely possible to rehabilitate its eyesight and the child suffers from stereoblindness.
When the lazy eye has been rehabilitated the squinting must be straightened out. This can be done through the use of glasses or a combination of glasses and surgery.