StrabismusTreatment & Surgery
What is Strabismus (squint)?
Strabismus, commonly known as squint, is a condition where the eyes are misaligned and do not point in the same direction at the same time. This can affect not only vision but also confidence, appearance, and daily activities such as school performance or work that require clear and coordinated focus. Eye misalignment may become more noticeable when a person is tired, daydreaming, or concentrating on objects for long periods.
- Misaligned and Point in Different Directions?
- Misaligned Only When Daydreaming or Tired?
- Misaligned When Trying to Focus to See Clearly?
- Having Double Vision, Causing You to Tilt Your Head to Focus?
Appointment
Let our eye specialist and trained orthoptist conduct a detailed eye check to determine if you have strabismus or not, as well as its severity.
Left untreated, strabismus will lead to worsening vision and other conditions such as lazy eye. Hence, our prompt and personalized treatments will help realign your eyes properly and regain clear vision.
On top of vision issues caused by strabismus, the appearance of misaligned eyes can be distressing to patients as well. With the right treatment, you can fix both visual and appearance issues effectively all at one go.
Ophthalmologist Dr Leo Seo Wei is an eye doctor in Singapore with over 20 years of experience treating adult and paediatric strabismus effectively. Though strabismus can sometimes occur in adults, it is usually seen in children. With Dr Leo also being a Paediatric Ophthalmologist, you can rest assured that your little ones will receive attentive, interactive and specialized eye care.
Our eye clinic in Singapore is equipped with modern medical technology that can diagnose and treat strabismus in a safe and effective manner.
Symptoms of Strabismus (Squint)
Strabismus (squint) can present with a variety of signs that may affect how the eyes look or how a person uses their vision. Recognising these symptoms early can help ensure timely assessment and appropriate management.
- Eyes that do not appear to be looking in the same direction at the same time
- Eyes that do not move together when looking at an object
- Frequent squinting or closing of one eye, particularly in bright sunlight
- Tilting or turning the head to look at something
- Double vision
- Poor or faulty depth perception
- Eye strain and headaches
- Difficulty reading
- Burning sensation or discomfort in the eyes
Causes & Risk Factors of Strabismus
Strabismus can develop due to a range of underlying factors that affect how the eyes and brain work together to control eye alignment. Being aware of the possible causes and risk factors can help identify individuals who may benefit from early assessment and treatment.
Types of Strabismus We Treat
Our eye specialist diagnoses and treats several types of strabismus, which may vary depending on the direction and pattern of eye misalignment.
What to Expect During a Strabismus Evaluation
Treatment for strabismus is tailored to each individual and may involve different approaches to improve eye alignment and visual function. The most appropriate treatment is determined based on the severity of the condition, the patient’s age, and the underlying cause.
In milder cases of strabismus, non-medical treatments such as spectacles, eye patches and lifestyle changes may be sufficient to strengthen the affected (and weaker) eye and treat the refractive error, thus correcting the misalignment.
In more serious cases of strabismus, the muscles that move the eye will be operated on, either to loosen or tighten them. This changes the pull of the eye, thus correcting the misalignment.
What Happens During Strabismus Surgery?
The procedure typically involves the following steps:
Anaesthesia is administered
The surgery is usually performed under general anaesthesia. In selected cases involving cooperative patients, topical anaesthesia with numbing eye drops may be used.
A small incision is made
The surgeon makes a small incision in the conjunctiva, the clear membrane covering the white part of the eye, to access the eye muscles.
Eye muscles are adjusted
The eye muscles are repositioned to improve alignment. This may involve moving the muscle to a new position or shortening it to strengthen its function.
Sutures are placed
In most cases, absorbable sutures are used, which dissolve naturally over time. Non-absorbable sutures may be used only when necessary.
The conjunctiva is closed
The conjunctiva is placed back over the surgical site and secured with absorbable sutures to allow proper healing.
Pre-Surgery Preparation for Strabismus (Squint)
Before undergoing strabismus surgery, your doctor will review your medical history to ensure the procedure can be performed safely. Inform your doctor about any existing medical conditions as well as any history of allergies or reactions to medications, drugs or food.
You should also let the doctor know if there is a history of bleeding or clotting disorders, or if you are taking medications or herbal supplements that may thin the blood as these may increase the risk of bleeding. For children scheduled for surgery, parents should inform the doctor if the child becomes unwell in the days leading up to the procedure. Additionally, it is important to follow the fasting guidelines provided before surgery to ensure the procedure can be carried out safely.
What Should You Expect After Strabismus (Squint) Surgery?
After strabismus surgery, most patients are able to return home on the same day. During the healing period, some temporary symptoms and care requirements are expected.
- Mild bleeding in the tears and crusting around the eyes for a few days.
- Eye redness that may persist for several weeks.
- Temporary eye discomfort or irritation.
- Temporary double vision that usually improves over time.
- Antibiotic and anti-inflammatory eye drops will be prescribed for several weeks.
- Avoid swimming and strenuous activities for at least four weeks.
- Follow-up appointments will be scheduled to monitor eye alignment, vision and eye pressure.
- In some cases, additional surgery may be recommended if misalignment persists.
Complications of Strabismus
Untreated strabismus can result in complications that affect vision and eye coordination. Early diagnosis plays an important role in preventing these issues.
- Permanent loss of depth perception
- Amblyopia (lazy eye)
- Head tilting, neck strain
- Social anxiety / appearance concerns
- Worsening misalignment over time
FAQs on Strabismus & Strabismus Treatment
- There are many ways strabismus can be caused. Sometimes it is due to a disorder in the part of the brain that controls eye muscles and movements. In order for the eyes to move together, the muscles in both eyes must be balanced and coordinated.
- Other times, it can be caused by refractive errors, focusing problems, tumours or nerve injuries.
- Aligned Eyes: Both eyes are able to aim at the same spot. The brain then combines both images into one single 3D image. This is what gives us normal depth perception.
- Misaligned Eyes: When one eye is misaligned, two different pictures are now transmitted to the brain. In a child, this is especially harmful because the formative brain will then learn to ignore the image received from the misaligned eye, and sees only the image from the aligned eye. This causes the child to lose depth perception.
- When people develop strabismus in adulthood, they tend to develop double vision instead, because their brains have already learned to receive images from both eyes and is not able to ignore the image transmitted from the misaligned eye.
- Young children often do not see double vision – they tend to lose depth perception instead.
- Cerebral Palsy
- Down Syndrome
- Hydrocephalus
- Brain Tumours
- Prematurity
- Apart from loss of depth perception, it can also lead to amblyopia – Lazy Eye. This is when vision in the weaker (misaligned) eye continues to deteriorate, because the brain keeps favouring the stronger (aligned) eye.
- Depth perception and peripheral vision may be affected
- Eyestrain and headaches may occur
- One may start turning his or her head to see in certain directions and to avoid double vision
- Usually, no. You or your child should start treatment as soon as symptoms show up, because if not, the problem may continue into adulthood and even worsen.
- It is never too late to restore normal alignment to the eyes!
- Not at all! This is typically an outpatient procedure, and a safe and established one at that
- It simply loosens or tightens the muscles that control the eye, thus correcting the alignment
- Do note that this is usually as a last resort – milder cases usually only require glasses or eye patches to treat
Strabismus cannot always be prevented, as it may be related to factors such as genetics, underlying eye conditions, or how the eye muscles and brain coordinate eye movements. However, regular eye examinations can help detect early signs of misalignment and allow timely treatment to reduce the risk of vision problems.
The cost of strabismus surgery can vary depending on several factors, including the complexity of the condition, the number of eye muscles involved, and whether the procedure is performed in a private hospital or surgical centre. A detailed assessment by the ophthalmologist will help determine the most appropriate treatment plan and provide a clearer estimate of the expected costs.