Cross-eyed is a condition when the position of the two eyes is not aligned and does not point in the same direction. This condition occurs because the muscles of the two eyeballs cannot coordinate to regulate the direction of the eyeball, so that both eyes see different objects.
Squint treatment can be done by various methods, namely by using glasses, eye patch, eye drops, or through eye muscle surgery. Both the goggles and the blindfold work by "forcing" the squinting eyes to work, and masking normal eye sight. In this way, the crossed eyes will act as the dominant eye, so that the eye muscles will be trained by themselves and can focus both eyes in the same direction.
Eye drops also play a role in treating squinting eyes with the same principles as eyeglasses and eye patch. Eye drops used contain atropine which works by blurring normal eye vision for several hours. If all of these methods cannot treat squint, the patient can undergo eye muscle surgery to treat squint.
Indications for Squint Treatment
Someone will be recommended to undergo squint treatment if they experience symptoms, such as:
- Double vision.
- Eyes that are not focused in the same direction.
- Loss of vision from one eye or not being able to see in detail.
- Irregular eye movements, due to poor eye coordination.
Symptoms of squint can occur occasionally or continuously. Keep in mind that children who suffer from squinting eyes are often not aware of these symptoms. Crossed eyes in children are generally realized by adults, especially teachers and parents. Children who experience double vision often find it difficult to see an object and can affect their learning process. Sometimes, children do not feel double vision because the development of amblyopia (lazy eye) in them is faster than in adults.
Warning for Squints
In general, there are no special conditions that cause a patient not to undergo squinting surgery at all. However, to avoid complications from cross-eyed surgery, patients should inform their illness to the doctor before undergoing surgery. Some conditions that can increase the risk of cross-eye surgery complications are:
- Elderly.
- Have a history of diseases that can interfere with blood circulation, such as diabetes and hypertension.
- Have a history of eye muscle surgery before.
Cross-eyed surgery is done by rearranging the eye muscles that cause poor coordination between the eyes. The amount of eye muscle that is corrected during this surgery varies according to the doctor's diagnosis. However, the more eye muscles that are corrected by squinting surgery, the higher the risk of complications, especially ischemic anterior segment of the eye.
Preparations for Squint Treatment
Before deciding to recommend a patient undergo cross-eyed surgery, the doctor will ask for information about the type of treatment the patient has had before. If the doctor decides to operate, the patient will undergo an eye examination to determine the severity of the squint. The main examination is the examination of eyeball or orthoptic movements. In addition to eye examinations, patients will also undergo a general physical examination to determine their health condition before surgery.
If the patient is taking blood-thinning medications, such as aspirin, warfarin, or heparin, the doctor will ask the patient to temporarily stop taking the drug. Medications and other supplements that patients consume should also be notified to the doctor. Patients will be asked to fast before surgery to avoid side effects from the anesthetics, such as nausea and vomiting. If the patient is suffering from a disease other than a squint, the doctor will delay the operation until the patient is well enough to undergo the operation.
Squint Treatment Procedure
Squint treatment with surgery on children is done in a state they are unconscious after being given anesthesia. Children can feel anxiety before surgery because it is separated from parents. These conditions can be overcome by doctors by giving sedatives to children. Squint eye surgery in adults can be done in a conscious or unconscious state. Adults can choose which anesthetic to use during surgery, whether local or total anesthesia.
After the anesthesia works, the ophthalmologist will open and hold the patient's eyelids with a speculum. After that, the doctor will make a small incision (incision) on a thin clear membrane that covers the white part of the eye (conjunctiva). Through this small incision, the doctor will correct and rearrange the eye muscles that cause the patient's eyes to squint. Squinting surgery can be done either on one eye or on both eyes.
Eye muscle surgery is done by strengthening or weakening the eye muscles to improve the coordination of the movements of the two eyeballs. Strengthening the eyeball is done by cutting (resection) the muscle or tendon of the eyeball. While the weakening of the eye muscles is done by releasing the eyeball muscles, then put back on the point near the back of the eyeball or called eyeball muscle recession. This process can be done on adults or children.
Squint eye surgery generally lasts for 1-2 hours. Especially in adults, eye muscles that are regulated and corrected during surgery can be temporarily placed first. Patients whose eye muscles are temporarily placed, can undergo eyeball movement testing after they regain consciousness after surgery. If it is felt that the coordination of the movements of the two eyeballs is not perfect or is still squinting, the patient will undergo surgery again to rearrange the eye muscles. If the squint is gone and the coordination of the movements of both eyes is good, the muscles of the eyeball will be installed permanently.
After Squint Treatment
Squint surgery is generally done without hospitalization, which means the patient can go home the same day after the operation is finished. The patient will feel itching and pain in the eyes for several days after surgery. However, avoid scratching the eyes to maintain the results of surgery and prevent infection. In addition, the patient should keep the operated eye clean and avoid dust and other objects or materials that can cause irritation. If needed, the doctor can give antibiotics in the form of drops or ointments to prevent eye infections.
The doctor will arrange a control schedule for the patient for several weeks after surgery. During control, the doctor will monitor the condition and healing of the eyes post-surgery. Some people who undergo cross-eyed surgery can experience post-operative vision problems, especially children. Children who experience postoperative visual impairment are advised to continue wearing eye patches to train weaker eyes after undergoing surgery. Therapy with the blindfold not only trains weak eyeballs, but also trains the brain that translates vision from the eye. Adults who have had cross-eyed surgery and have vision problems are still advised to wear glasses, until vision problems can be overcome.
Risks of Squint Eye Treatment
Every operation has a risk of complications. Squint surgery can also cause complications, although rarely. Some risks of complications that can occur due to cross-eyed surgery are:
- Eye infections.
- Eye bleeding.
- Eyes are red and feel dry.
- Double vision.
- Abrasion or erosion of the cornea of the eye.
- Retinal detachment.
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