Peo­ple in­stinc­tive­ly tend to shy away from health­care, par­tic­u­lar­ly eye care. Very of­ten, we wait un­til some­thing be­comes an ex­treme­ly press­ing or ur­gent mat­ter be­fore we at­tempt to ad­dress it.

An eye ex­am by your doc­tor should take pri­or­i­ty in your in­di­vid­ual health­care, as in most cas­es the ear­li­er an ill­ness is de­tect­ed, the greater the like­li­hood of a pos­i­tive out­come. This es­pe­cial­ly holds true when it comes to chil­dren, the fu­ture of this coun­try.

Stra­bis­mus or squint, is an eye con­di­tion where the eyes are not aligned, which means that they are look­ing in dif­fer­ent di­rec­tions.

Lo­cal­ly, this is known as a “cokey eye” or “cross-eyed”. One eye may be look­ing straight ahead at an ob­ject (the fix­ing eye), whilst the oth­er may be turned in, out, up or down (the de­vi­at­ing eye). Some­times, the fix­ing eye and the de­vi­at­ing eye can even swap around or al­ter­nate! This is known as an al­ter­nat­ing squint.

Who can de­vel­op a squint?

Any­one, whether child or adult, can de­vel­op a squint. Child­hood squints may be present from birth or de­vel­op as your child gets old­er. New­born ba­bies some­times have an “oc­ca­sion­al squint” up un­til around three to four months of age.

By six months of age, ba­bies should be able to fol­low ob­jects with both eyes fix­ing to­geth­er.

It is at this age that a squint some­times be­comes no­tice­able. How­ev­er, a squint can ap­pear at any point in your child’s de­vel­op­ment. If you think that you have no­ticed a squint but you are un­sure if it’s there, a good tip is to look back at pre­vi­ous pho­tos tak­en of your child to see if it was there be­fore.

In fact, a lot of squints are first dis­cov­ered while look­ing at old pho­tographs! What caus­es a squint? There are many caus­es of squint in chil­dren, rang­ing from re­frac­tive er­rors (need for glass­es) to hav­ing more se­ri­ous life-threat­en­ing caus­es such as can­cer­ous tu­mours in the eye.

As such, if you do no­tice a squint, you MUST have your child as­sessed by an oph­thal­mol­o­gist (spe­cial­ist eye doc­tor) or oth­er eye care provider as soon as pos­si­ble!

Will a squint

go away if I leave it?

While a small mi­nor­i­ty of chil­dren may ex­pe­ri­ence their squint re­solv­ing on its own, more of­ten than not, this con­di­tion wors­ens.

There are sev­er­al com­pli­ca­tions as­so­ci­at­ed with squint, in­clud­ing am­bly­opia (pro­nounced am-blee-o-pee-ah) or “lazy eye.”

Am­bly­opia is a con­di­tion where the con­nec­tions in the eye that are mis­aligned or de­vi­at­ed be­come un­der­de­vel­oped, so the child is un­able to see well in that eye. Am­bly­opia can some­times be se­vere enough to cause blind­ness.

An­oth­er in­her­ent psy­cho­log­i­cal ef­fect of squint­ing is that the child may de­vel­op self-es­teem is­sues with their eye ap­pear­ance.

Oth­er com­pli­ca­tions in­clude dou­ble vi­sion, blur­ry vi­sion, headaches, and fa­tigue.

What to do if my child has a squint?

If your child has a squint, an as­sess­ment by an oph­thal­mol­o­gist (spe­cial­ist eye doc­tor) is a ne­ces­si­ty.

In fact, even in the ab­sence of a squint, reg­u­lar eye check­ups by your friend­ly neigh­bour­hood eye care provider aren’t a bad idea.

Your doc­tor will do a thor­ough his­to­ry and ex­am­i­na­tion, en­quir­ing about any is­sues and con­cerns you or your child may have. This may in­clude vi­sion test­ing with var­i­ous charts de­pend­ing on their age and shin­ing a light on­to, as well as in­to, the eyes. Tests us­ing var­i­ous in­stru­ments, such as spe­cial glass­es, can al­so be in­cor­po­rat­ed in­to the ex­am.

It is al­so good to know that none of these tests are in­va­sive and the tests will not cause your child any harm. Are there treat­ments for a squint? The man­age­ment of squint may vary from child to adult.

Every child is dif­fer­ent, and as such, treat­ment op­tions must be dis­cussed with your eye doc­tor, with the goal of cre­at­ing the best man­age­ment for your child’s spe­cif­ic needs.

Most of­ten, treat­ment meth­ods in­clude the use of eye­glass­es, as well as spe­cialised glass­es called prisms. Oth­er treat­ments in­clude var­i­ous eye ex­er­cis­es and patch­ing. Sur­gi­cal in­ter­ven­tion is al­so an op­tion your doc­tor may dis­cuss with you for op­ti­mal func­tion­al re­sults.

Squints aren’t con­fined to chil­dren. Adults can have them too. Rest as­sured, your eye doc­tor won’t turn you away be­cause your favourite songs are from the 1980s and your bed­time is af­ter the 7 pm news!

Every­one can and should have an eye ex­am as rec­om­mend­ed by their eye care provider. The fre­quen­cy of these eye ex­am­i­na­tions is de­ter­mined by your age and whether you may have oth­er con­di­tions such as di­a­betes, which can af­fect eye health and vi­sion. Who knows, af­ter your ex­am, you just might end up “see­ing yuh way.” 

Dr He­mant Daniel is em­ployed at the Eye Unit, Er­ic Williams Med­ical Sci­ences Com­plex. He is cur­rent­ly pur­su­ing post grad­u­ate train­ing in Oph­thal­mol­o­gy at the Uni­ver­si­ty of the West In­dies.

This col­umn is sup­plied in con­junc­tion with the T&T Blind Wel­fare As­so­ci­a­tion

Head­quar­ters:

118 Duke Street,

Port-of-Spain, Trinidad

Email: ttb­wa1914@gmail.com

Phone: (868) 624-4675

What­sApp: (868) 395-3086