How do you treat adult squint?

If I see a patient with a squint the treatment depends on the cause of what the problem is. If the problem is cosmetic, and there is no diplopia, which is more common in people who have had squints in childhood and had surgery in childhood but the squint has drifted, then, in most cases the treatment is surgical. And that involves an operation under a light general anaesthetic, and the procedure lasts about 40-45 minutes.

And what one does is operate on the muscles of the eyes, which are like little elastic bands and you’re tightening and loosening the elastic bands to alert the alignment of the eye. The procedure afterwards leaves the eye a little bit sore and irritable for three or four days. But that settles over a period of a couple of weeks. And the success rate of that surgery in aligning the eyes is excellent.

Occasionally surgery isn’t appropriate and one would use botulinum toxin injections. And interestingly, botulinum toxin, which now we all know is used cosmetically, was first ever used in squint surgery. It was an American in San Francisco who essentially invented botulinum toxin for the use of squint. Ever since then it has become widespread in other areas.

If the squint is causing double vision, then it may simply be that you can correct that with prisms in glasses. So if the misalignment of the eyes is small, one can incorporate prisms in glasses and that would control the double vision as long as the glasses are being worn. If the size of the squint is large, then the prisms become too thick in the glasses and surgery will be indicated or less commonly botulinum toxin.

More about Robert Morris

Rob Morris is a Consultant Ophthalmic Surgeon at The Grange Eye Consultants. His special expertise is in cataract and refractive surgery, including Refractive Lens Exchange, and adult squint. He has over 30 years experience in treating people with eye problems. Rob Morris founded Grange Eye Consultants to manage the increasing demand for more complex refractive surgery. He leads clinical trials investigating novel eye treatments. He is currently Medical Director at Optegra Eye Hospitals.