Adult Squint

  • Conditions Treated

    Adult squint

  • Treatable Areas

    The eye

  • Practitioner

    Jane Olver

  • Downtime

    1 to 3 weeks

  • Your Specialist

Jane Olver

Consultant Ophthalmic Surgeon
Eyelid & Lacrimal Specialist

More about specialist

Adult Squint

The Problem

Squint is also known as strabismus. The eye is turned in a different direction to the other. This inclination of the eye appears because of an incorrect balance of the eye muscles, which can be traced to various different causes. A lot of people think that in most of the cases children are affected by squint, but there are also older patients with squint. At Clinica London Ms Jane Olver concentrates on adult squint patients with Mr Ashwin Reddy, Paediatric Ophthalmic Surgeon. He looks after the majority of paediatric patients and after Children´s Strabismus and Amblyopia.

Types of Adult strabismus:

  • Consecutive strabismus: This is where an eye drifts out again after strabismus surgery as a child. As the patient gets older, especially if one eye is amblyopic (lazy) and does not fix, then the eye cannot always stay in the position it was placed. So the eye subsequently slowly drifts out.
  • Restrictive strabismus: This is where one muscle or more does not move effectively as it is scarred or enlarged. For instance, after trauma when it is entrapped in a small orbital fracture, has a direct scar, where there is enlarged muscles in thyroid eye disease or after some ENT surgery including orbital decompression.
  • Nerve palsy: This is 3rd, 4th or 6th nerve palsy which can give a combination of squint, double vision (either vertical or horizontal) and eyelid ptosis or small compensatory head posture.
  • Myopathy: This is where the muscles are weak and hardly move. They often have a both eyelids dropping (ptosis) so the emphasis is mainly on the eyelid surgery as they rarely get double vision.

The Treatment

Assessment

The initial assessment will involve an orthoptist assessment with Mr Joe McQuillan and a medical consultation with Ms Jane Olver. Mr McQuillan will measure the visual function and eye motility with cover testing and prisms. He will also test the patient’s ability to use the eyes together, called binocular vision, and the amount of stereopsis. He will detect whether the patient has a lazy eye. This is followed by a medical consultation with Ms Jane Olver. She will use the results of the orthoptist assessment and provide the patient with a more detailed assessment. Ms Jane Olver takes the necessary eye measurements to diagnose the type of strabismus. Then Ms Jane Olver discusses whether neurological opinion or further investigations are required before the surgery is considered. After this Ms Jane Olver explains the type of surgery and its benefits and risks, or whether there is a non-surgical alternative. Depending on the outcome of the assessment and the opinion of the consultant the treatment options can be glasses or injection of botulinum toxin into one of the tiny eye muscles.

Squint surgery

The surgery is done as a day case under general anaesthesia and takes between 30 to 45 minutes. It is microscopic surgery where one or more muscles are delicately moved in relation to the eye and tiny stitches reattach the muscles. Sometimes Ms Jane Olver uses ‘adjustable sutures’ which allows a following small refinement under local anaesthetic within the first 24 hours, in the clinic. If there is no need of correction, the suture is hidden and is dissolvable. So it disappears after a few weeks.

The Results

After squint surgery, there are antibiotic steroid drops to use for the first 1 to 3 weeks. There is a first follow-up visit during that time, to check the healing. At the post-operative orthoptic assessment, we check with measurements the improvement. We usually require three follow-up visits at week 1, 4 and 12.

Surgery carries a success rate of around 80%. Some patients (less than 10%) need further surgery, dependent on what they have already had done.

Talk to us about your options on 020 7935 7990

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“Dr Jane Olver was fantastic! She was so caring and sweet and it was clear that she knew what she was doing – very professional! I am absolutely over the moon with my results now!”
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