Early Treatment Urged For Squint In Children

Press, Volume CIII, Issue 30499, 22 July 1964, Page 8

Early Treatment Urged For Squint In Children

Each year eye specialists are consulted by many persons with defective vision in one eye, as a result of a squint, who have sought treatment too late for anything to be done for the sight in this eye, said a leading Christchurch ophthalmologist in an article prepared for the New Zealand Foundation for the Blind.

Many of these eyes could have been greatly improved if early treatment had been sought, but the main reason for this not being done is a lack of understanding or the fundamental cause of strabismus, “crossed eyes” or squint, to give it its common name.

Basically, the cause of any squint is the inability of the person concerned, for one reason or another, to use the eyes together, and to fuse the images seen with individual eyes into one composite, three dimensional picture in the brain.

To prevent themselves from seeing double, these people unconsciously use

only one eye at a time, and disregard the image seen with the other eye. Consequently there is then no real reason why the two eyes should remain looking in the same direction, and the eye that is not being used frequently swings inwards in relation to the other (and occasionally outwards). If it is always the same eye which turns, it can easily be seen that this eye will become “lazy,” or worse still, in the case of early onset of squint, the central vision (used for reading and the appreciation of all fine detail) will not develop at all. Not True Because of this lack of understanding of the true position eye specialists frequently hear the remark from parents “I did not bring him along earlier because I knew nothing could be done until he was two years old” (or three years, or some other arbitrary figure). This could perhaps be true where surgery, or whatever method is to be used to straighten the eye, is concerned, but it is not true as regards the much more important aspect of retaining, or developing, good sight in the squinting eye. A child who is noticed to develop a squint should be seen by an eye specialist at that time, and not at any special age. The eyes will then be checked to see whether the squint is due to some congenital abnormality, not by any means uncommon. But if both eyes appear normal, attempts will be made to get the child to use the squinting eye. The earlier this is done the greater are the chances of success.

Possibly the commonest reason for the delay in taking children with squints for advice is the assumption that the child will “grow out of it”, as the parents have seen or heard of so many who have.

Contrary to popular opinion, it is almost unknown for a child to grow out of a true squint, and the reason for this becomes clear when one looks at the basic cause of squint. When a child “grows out of a squint” it is almost certainly the false squint, or appearance of squint which the broad, flat bridge of the nose gives to so many children. As the child’s nose develops, the appearance of squint disappears.

Another common cause of the delay in seeking treatment is that parents “thought it was just due to teething” and would correct itself. Teething, however, is not a cause of squint, but squint often appears first when a child’s general health is upset for any reason. To sum up, squint is an illunderstood, complex problem with many different causes, and advice should be sought from a doctor who specialises in diseases of the eye when it first appears, and not at any special age.