Adult Concerns over Squints

A major concern of individuals with squints is the effect on their cosmetic appearance. Double vision (diplopia) is one of the most troublesome visual disorders a patient can experience. This is when a person sees two images of the same object some or all of the time. The two images may be vertically separated (one on top of the other) or horizontally separated (side by side) or both (oblique). The ability to read, walk and perform common activities is suddenly disrupted. The management goal is to establish clear binocular single vision.

Compared to binocular vision, adults with strabismus may have a decrease in their field of vision, absence of stereopsis or depth vision, decreased visual acuity and impaired spatial orientation. Individuals with squints are disadvantaged in visual motor skills, form and colour, and of appreciation of the dynamic relationship of the body to the environment, which facilitates control of manipulation, reaching and balance.

Squints may manifest as difficulties in eye hand coordination, clumsiness, bumping into objects and / or people, ascending or descending stairs or kerbs, crossing the street, driving, various sports and other activities of daily living which require stereopsis and peripheral vision.

Squint Treatments

Surgical Treatments

The definition of a satisfactory outcome in a given case is a matter for discussion between the patient and eye surgeons. The type and amount of surgery to perform for a particular squint is a decision for our experienced surgeons. This demands an accurate pre-operative decision and necessitates meticulous surgical planning and accurate prediction of surgical outcome.

The surgical aims are re-alignment of the eye muscles where necessary to achieve satisfactory function and cosmetic appearance. This can mean that the non-squinting eye may be operated on. Since some patients may recover function over time, surgery may not be considered initially. Patients need to be advised that, whilst accuracy in measuring and operating upon strabismus is essential, the response to surgery is variable and cannot be guaranteed. Our surgeons employ good practice and discuss the actions necessary if the desired surgical outcome is not achieved.

Prisms, refractive lenses, vision therapy, eye patching and pharmacologic measures have been used to help patients achieve fusion (alignment of the eyes) and alleviate diplopia, in addition to surgery. Some patients will adapt by suppressing the vision of one eye to eliminate their diplopia. An additional technique is the use of Botulinum toxin.


Botulinum Toxin (Botox)- Therapeutic Uses

Introduction: What is Botulinum Toxin (Botox)?

Botulinum toxin (Botox) is a complex protein produced by the anaerobic bacterium Clostridium botulinum. It produces a total of seven different toxins all of which have the same end result, the paralysis of muscle. One of the toxins, Botulinum Neurotoxin Type A, is now available for medical use under the trade name Botox. Advantage can be taken of the effects of Botox to alleviate muscle spasm or to weaken a muscle for therapeutic purposes. In therapeutic applications, minute quantities of botulinum neurotoxin type A are injected directly into selected muscles. Ocular conditions that respond include squints and spasm of the eyelid (blepharospasm).

Botox therapy is invasive. Its use should be reserved for patients in whom an ophthalmic diagnosis has been established with reasonable certainty. At the Ophthalmic Surgery Centre, Botox therapy is conducted by a skilled interdisciplinary team and sophisticated instrumentation and electromyography are available to ensure valid diagnosis, state-of-the-art treatment, and appropriate follow-up. Our ophthalmologists who administer this drug are highly trained in its use and qualified to manage any complications. Botox treatment of ophthalmic conditions requires proper identification of the affected eye muscles.