Adult Squint2018-12-12T17:58:25+00:00

Adult Squint

  • Conditions Treated

    Squint (strabismus)

  • Treatable Areas

    The eye

  • Practitioner

    Naz Raoof

  • Downtime

    1 to 3 weeks

  • Your Specialist

Naz Raoof

Consultant Ophthalmologist Paediatrics, Strabismus &
Neuro-Ophthalmology

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 Naz Raoof, is the Paediatric Ophthalmic Surgeon, Neuro-ophthalmologist and Adult Strabismus surgeon. She looks after children and adults with squints (strabismus).

Types of Adult strabismus:

  • Exotropia: This is where one eye diverges compared with the other, and can be associated with poor vision in one eye, or worsening of a childhood divergent squint. In these childhood exotropias, control of the squint can become more difficult with age, and surgery as an an adult is possible.

  • Esotropia: This is where one eye converges relative to the other. It can be a long-standing childhood squint or acquired in adulthood. In both cases, treatment is usually possible.

  • 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 Naz Raoof. 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 Raoof. She will use the results of the orthoptist assessment and provide the patient with a more detailed assessment. Ms Raoof takes the necessary eye measurements to diagnose the type of strabismus. Then Ms Raoof discusses whether neurological opinion or further investigations are required before the surgery is considered. After this Ms Raoof 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, prisms 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 usually takes an hour if two muscles are being operated on. One or more muscles are delicately moved in relation to the eye and tiny stitches reattach the muscles. Sometimes Ms Raoof uses ‘adjustable sutures’ which allows a following small refinement under local anaesthetic, usually a couple of hours after the procedure. 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 4 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

The best way to figure out whether this is something for you is to give us a call. We can answer any questions you have and help you clarify which treatment options are best for you.

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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!”

Toni C.

“Jane Olver is your woman – I wish I had found her at the start. I will be forever grateful for her care and expertise.”

Nancy W.

“Just wanted to thank you for your exceptional assistance with my eye condition. I was so worried but you really helped me feel at ease.”

David T.

“I felt much better after speaking to you and being reassured. I am much calmer and actually got some sleep last night.”

Catherine M.
“I was deeply impressed by the politeness and empathy shown to me. I found the surgery very peaceful and beautifully decorated and I hope to see Jane again soon.”
Jeffrey W.
“I highly recommend Jane Olver. The whole experience was calm and highly professional.”
Lorraine M.
“I am writing to you to say thank you to you, Cloe and Jane for taking care of me this week. You were all really lovely and professional and I am very grateful. Big cheer for The Clinica London Team.”
Rick A.
“Many thanks for taking care of my ptosis surgery today. I am now back home and resting but wanted to send a quick note to thank you for taking such good care of me.”

Charmaine
“The treatment was a great success; within 24 hours of starting the treatment the pain and swelling subsided and as a result, I was able to enjoy a great holiday in Argentina.”
Simon
“Thank you, my eye is recovering brilliantly (you almost can’t see I had it). Jane was amazing, please pass on a huge thank you.”
Jen

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