Another bump on our journey ...

I have not been blogging much again, have I? Well.. as some might have read it off my fb status updates, Jaden is going through another bump in our journey towards recovery and this time, it concerns his eyes.

His situation currently? Below's excerpt from will help you understand his situation at the moment and he will be having his EUA (Examination Under Anesthesia) this Thursday, early in the morning. *sigh*

Strabismus, commonly called squint, is a condition in which the eyes are not looking in the same direction.It is the misalignment of the two eyes so that both the eyes are not looking in the same direction. This misalignment may be constant, being present throughout the day (constant squint), or it may appear sometimes and the rest of the time the eyes may be straight (intermittent squint).

It is a common condition among children. It may also occur in adults.

WHAT CAUSES SQUINT ?

1. Paralysis of one or more muscles responsible for eye movement (paralytic squint).

2.Sometimes a refractive error hypermetropia (long sightedness) not corrected by appropriate spectacle or non usage of spectacle may lead to inward deviation( convergent squint) of the eye ( accommodative squint).

3. Poor vision in an eye because of some other eye disease like cataract, uncorrected refractive error, corneal opacities, vitreous opacities, macular diseases, optic nerve disorders etc. may also cause the eye to deviate outwards (divergent squint). On one eye can be squinting (Unilateral squint) or both eyes can deviate alternately ( Alternate squint)

Therefore it is important in all the cases of squint, especially in children, to have a thorough eye checkup to rule out any other cause of loss of vision.

WHAT ARE THE PROBLEM WITH SQUINT ?

1. Normally the images from both eyes are superimposed in brain and we see only one image producing 3 Dimensional picture. In children brain would ignore the image coming from the deviated eye because of poor quality of image from deviated eye, and thus sees only one image. And in the process, he loses the depth perception. This suppression of the image from the deviating eye results in poor development of vision in this eye, which is known as amblyopia which can unilateral or bilateral.

2. In case of paralytic squint , where vision is fully developed, brain can not ignore the image from either eye, and therefore sees double vision (Diplopia). This can be very annoying and may interfere with work.

WHAT ARE THE SYMPTOMS OF SQUINT ?

In a child, the parents may notice the deviation of eyes.

Adults may notice double vision, or misalignment of the eyes.

EXAMINATION OF SQUINT PATIENT:

The eyes are checked thoroughly to see for any refractive error, any defect in visual pathways such as Lid ,cornea, lens, vitreous, retina, optic nerve that may be responsible for squint.

In younger children Examination under anesthesia (EUA) is undertaken.

Degree of squint, whether squint is unilateral or bilateral, whether paralytic or non paralytic, is ascertained.

Next the eyes are checked for presence of amblyopia. It is important to treat the amblyopia before treating squint.

TREATMENT OF SQUINT:

If there is any significant refractive error present, it is treated first. In some cases,a correction of refractive error is all that may be required to treat squint.

Treatment of Amblyopia (lazy eye)::

This is the most important aspect in squint treatment. Treatment of amblyopic eye is started as early as possible as best results are obtained if treated before the 10 years of age. Occlusion by various modes depending upon age is practiced and parents cooperation is of utmost importance in curing the disease.

Once amblyopia is corrected the squint is treated by surgery of either one or both the eyes. The surgery involves weakening or strengthening of the relevant muscles to restore the balance and to get a good coordination. In some cases with double vision, prisms may be added in the glasses to ease the symptoms.