Can you cure a squint or strabismus with eye exercises?
What conditions do eye exercises, patching, glasses and prisms address?
Both children and adults can get squints. These are assessed and addressed by a combination of eye exercises, patching, glasses and prisms, depending on the nature of your squint.
A squint is when one eye looks in a different direction from the other eye. Medically we call a squint ‘strabismus’, and there are different therapeutic options that a specialist ophthalmologist will consider based on each person’s case. At Clinica London, Ms Naz Raoof looks after both children and adult patients with squints.
She can correct or rehabilitate some squints with orthoptic exercises or with prisms. A full orthoptic assessment is required for all patients with squint prior to seeing Ms Raoof. The orthoptist will first take measurements of the eyes using special prisms, as well as examine the eye movements and how well your eyes work together.
At Clinica London Ms Naz Raoof is the Consultant Ophthalmologist who will assess your child, or you as an adult, if you have an eye motility problem, squint (strabismus) or double vision. She will advise on eye exercises, prisms, glasses and whether surgery or treatment with botulinum toxin may be required.
How do you know eye exercises, patching, prisms or glasses are right for you?
You have to be assessed by the Orthoptist and by the Consultant Ophthalmologist who will listen to your history and examine your vision and eyes, doing special tests to obtain a full assessment. Ms Naz Raoof will then advise whether eye exercises, prisms and / or glasses are likely to solve your problem.
Ms Naz Raoof sees children and adults with squint, and she has to decide whether there is a need for glasses (refractive error) and if there is one, she can advise whether this is likely to help with your squint. Sometimes a prism may be suitable for older children and adults. In some patients, she will recommend botulinum toxin treatment or squint surgery. Children may require patching of one eye to help their visual development by treating a lazy eye.
In some children, a squint that is turning in called an esotropia or convergent squint may not require surgery, but rather just glasses. This is called an accommodative convergent squint. These children are at risk of developing amblyopia or a lazy eye in the eye that is converging and the paediatric Ophthalmologist Naz Raoof will help maximise vision development in that eye. The most effective way of doing this involves occlusion of the healthy eye using an eye patch. Once we have corrected the optical error and reduced or corrected the amblyopia, then if the convergent squint persists when the glasses are on, we can consider surgery as a next step.
Ms Naz Raoof at Clinica London also manages adult patients with a squint. A common type of adult squint she sees is a consecutive squint, where the eye is turning outwards. These patients have often started off with an eye turning inwards or converging, when they were much younger. They may have had glasses to correct a refractive error, possibly amblyopia treatment with patching and previous corrective squint surgery. As time passes, they may get a divergence of their eyes which requires Naz Raoof and the orthoptist to examine and take eye measurements. Then they can decide whether there is a risk of double vision with any future squint surgery. If there is not a risk of double vision or it is a very low risk, then she can do exploratory squint surgery to locate the muscles and undertake further surgery to place the eye in a better position. We often offer this type of surgery using adjustable sutures.
Both children and adults have squint surgery under general anaesthetic, either at the Harley Street Clinic if they are a child or adult. Squint surgery usually takes about an hour to an hour and a half, and is done as a day case.
After the squint surgery, the eye can be quite red and need eye drops for 4 weeks. For the first 24 hours, we usually put an eye pad on, unless the patient is very young and will not tolerate an eye pad.
In adult patients where Naz Raoof has used an adjustable suture, she may have to make a small adjustment of the squint stitch on the same day as the surgery, back at the clinic. Very often, however, the squint is just in the right place, and she doesn’t need to do any further adjustments.