It is a condition in which the two eyes do not look in the same direction at the same time. This misalignment of the eyes leads to 2 different images falling on the retina at the same time. As a result, Child sees double and eventually decides to either stop using one eye and makes it LAZY (leading to Amblyopia) or losses 3 D VISION.

Squinting of eyes can be congenital – since birth, Developmental – after few years of birth or Acquired – at any later time in life, due to trauma or nerve palsy

Up till 6 months of age, the eyes can appear to be having lack in co-ordination of movement.
If any Squint persists beyond 6 months of age, its not normal and parents need to seek a pediatric ophthalmologist s opinion.

OPTICS – by correcting the child s refractive error (i.,e glass prescription), many types of squints can be corrected
OCCLUSION – Patching of one eye is gold standard in management of lazy eye due to squint. It can occasionally reduce the amount of squinting by improving the vision in that eye.
ORTHOPTICS – Binocular vision Therapy or Dichoptic therapy often help correct minor squints and is increasingly used in practice these days as a conservative management before surgery
OPERATION – It’s the ultimate and one time solution for most squints

Surgery for squint essentially involves readjusting the muscle attachments on the white portion of the eye i.e the sclera. The entire surgery is performed outside the eye ball, and hence there is no risk of injuring the cornea, lens or retina which constitute the visual apparatus of the eye. Hence there is no risk of vision loss in squint surgery per say.
So precautions mainly include, avoiding dust and water from entering the eye for 5 days post op. Medicated eye drops will have to be instilled in the eye for 1 month. There is no restriction on any indoor activities and food. Mobile phone or ipad use at less than 40 cm distance should be avoided for 15 days.

Unfortunately, Laser beam does not pierce the eye muscles. Hence the entire squint surgery is performed manually by the surgeon with zero dependence on any technology or machine. It’s a completely manual and skilled procedure. There is minor bleeding while readusting the muscle insertions and hence the eye will appear red for anytime between 2 weeks to 6 weeks. They will become completely normal at the end of 2 to 3 months.

The prognosis of the squint surgery depends on the vision of the eye being operated. If the squint is detected early and adequate amblyopia treatment has made the vision in both eyes equal or 6/6, then the prognosis of squint surgery is excellent and the squint may not come back. However, if there is a delay in seeking an opinion and if lazy eye management is not possible at that age, and the surgery is performed in an eye with poor vision, then there are chances that the squint can recur.
But the good thing is, that there is no restriction on the number of times an eye can undergo squint surgery since its an extraocular procedure. So even in cases of recurrent or residual squint a resurgery can easily be performed.

Its different in different types of squint, but typically an esotropia (i.e inside squint) should be fixed as soon as possible, best prognosis is if it’s corrected before 18 months of age. For exotropia, the deviation can be observed and if persistent, increases or becomes constant, it should be operated within 2 years of first observed.

It depends on the number and the kind of muscles one needs to operate for optimum correction.
Cost ranges from 20 to 25 k per muscle (if 2 muscle surgery – 40 – 50 k, if 5 muscle surgery its 80 k to 1 lakh) + 5 to 10 k anaesthesia charges.

In the past because of the guidelines, squint was often dismissed in congenital and cosmetic causes and Mediclaim was rejected.
However in current times, we understand the fact thar squint affects the functionality of the binocular vision and in children if left uncorrected can lead to a lazy eye and loss of functional vision in presence of normal ocular anatomy. Hence few companies have started giving reimbursements for Squint surgeries.