SQUINT (STRABISMUS) IN ADULTS

A squint (or strabismus) occurs when one eye is not properly synchronised with the other eye. The affected eye might wander inwards, outwards but more rarely upwards or downwards. 

This can happen all the time or only sometimes, such as when you are tired or concentrating. A squint can cause eyestrain and/or double vision and also affects the appearance of the eye.

Causes of squint:

Squints can have a number of different causes, including:

  • A squint that was treated as a child but that has returned
  • Damage to the muscles in the eyes caused by accident or illness
  • A tendency to squint that has become harder to control over time

Non-surgical treatments for squints

A number of non-surgical treatments are available to help correct a squint. Depending on the type and extent of your squint, we may recommend:

  • Eye exercises which to help you to improve muscle control in your eyes
  • Glasses designed for long-sight which can help to correct squints that turn inwards. Prism glasses may be recommended for double vision and eyestrain
  • Injections of botulinum toxin (Botox) into the eye muscles which can improve some squints, although normally the results are not permanent

Surgical treatments for squints

Small incision squint surgery

In some cases, surgery may be possible to correct a squint. You may need squint surgery on one or both eyes. 

Mr Jain has pioneered small incision squint surgery in the UK. By making a small incision that is hidden under the lower eyelid, there is no visible scarring. 

Surgery is performed under general anaesthetic and usually lasts around half an hour or less, depending on the number of muscles being operated on. You should be able to go home the same day. The eye will be red after the procedure, but this should fade within three weeks and you will be given eye drops to reduce inflammation and prevent infection.

 

Small Incision Squint Surgery Incision (green) and Conventional Squint Surgery incision (red)

Conventional squint surgery

There are two types of conventional squint surgery.

Conventional squint surgery adjusts the six muscles that control the movement of the eye. The muscles are attached to the surface of the eye underneath the white area. By weakening or strengthening each affected muscle we are able to correct the eye’s position and then stitch the muscles into position using dissolvable stitches. You may also need to have stitches in the clear layer of the eye.

In some cases, however, rather than fully reattaching the muscles to the eye, we will reattach them loosely and then adjust them when you wake up after the operation. This is called adjustable stitch surgery. You will have local anaesthetic drops in your eyes, so you won’t be able to feel anything. 

By fine-tuning the position of your eyes in this way we will ensure the greatest chance of successfully correcting your squint. Not everyone will be suitable for this type of surgery though. Your ophthalmic surgeon will advise you on the best surgical option for you.

Risks of squint surgery

Squint surgery is performed under general anaesthetic so you will be asleep throughout the operation. As with all operations, there are some potential risks to consider.

The eye will be uncomfortable after surgery but should not be painful. The whites of your eyes will appear red after surgery, but this should gradually fade after a few weeks.

There is a very small risk of damage to the eye or vision or infection. Your surgeon will talk to you about the potential risks.

Squint surgery benefits

In most cases surgery to correct a squint is very successful and it will enable you to enjoy more comfortable vision without the eyestrain and discomfort caused by squinting.

Out of hours aftercare

Mr. Jain is always happy to receive calls if a patient is having difficulties after surgery. Call his secretary or the hospital at which the surgery was carried out and they will give him your contact details. If you have any further questions, please feel free to send us an email.

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Mr Saurabh Jain

Saurabh Jain Is a Consultant Ophthalmic Surgeon and Clinical Director of services at the Royal Free London NHS Foundation Trust.