There are many causes of squints, from congenital (born with it), a high refractive error, nerve weakness (stroke), and muscular problems. The ophthalmologist will diagnose the cause of the squint, and put together a plan to correct it.

Children can be born with a squint, or it can develop as they grow. Childhood squints do not usually cause double vision, but they do prevent the eyes from working together. If the eyes don’t function together, then the child’s development of depth perception will be affected. If the squint is not corrected the eye may become lazy and vision may worsen.

Squints may also have a negative psychological impact on children. They may be teased by their peers, causing them to become very self-conscious about their appearance.

Adults can also develop squints for various reasons. Adult-onset squints usually result in double vision, which is an extremely distressing symptom. Patients start seeing two of everything and may have to close one eye in order to focus clearly.

There are a few treatment options when it comes to squints. 

Your ophthalmologist will carefully assess the situation, and suggest a plan based on your specific case. In some cases, a pair of glasses may correct the squint (this is mostly in children). There are also eye exercises that can be done to help strengthen the eye muscles. However, if these methods are unsuccessful at correcting the squint, surgery may be advised by your ophthalmologist. 

Dr Olivia Read has performed hundreds of successful squint surgeries in almost two decades of practicing as an ophthalmologist. In her opinion, squint surgery can be extremely effective for both children and adults. This is supported by medical studies around the world.

According to The efficacy of strabismus surgery in adults: a review for primary care physicians by Burton J Kushner, “…most adult patients with strabismus can be successfully treated, with around 80% of patients achieving satisfactory alignment with one surgical procedure… The majority of adults will experience some improvement in binocular function after strabismus surgery even if the strabismus has been longstanding.”

The earlier the better. Most squints develop in children under three years old, and action should be taken to correct it before permanent damage occurs. In children, the eye that is affected by a squint may stop processing information, causing visual loss or amblyopia (also known as lazy eye). This may be permanent if the squint isn’t treated effectively. 

Early treatment is ideal, but adult squint surgery has also been proven to be effective. Depending on the severity of the squint and the causes, one or more surgeries may be required.

Squint surgery is a relatively minor procedure which usually takes around an hour for the surgeon to perform. Most patients are released on the same day that they have surgery. 

Depending on the case, it may be necessary to operate on both eyes – even if only one eye exhibits a squint. This will be assessed and advised by your ophthalmologist.    

What does the surgeon do during squint surgery?

If the ‘pull’ of one of the muscles around the eye is too strong, a recession procedure (weakening the muscle) can be performed. The eye surgeon detaches the relevant muscle from the eye and reattaches it farther back to weaken the relative strength of the muscle.

Alternatively, if the muscle is too weak, the surgeon may use a resection procedure (strengthening the muscle) to shorten the muscle and increase its pull on the eye.

These procedures help improve the alignment and function of the eyes, as well as improved cosmesis (physical appearance). 

Are there risks associated with squint surgery? 

As with any kind of operation, there are small risks involved. Risks of eye surgery to correct a squint include: 

• The possibility of further surgery. This is sometimes needed if the squint is severe. If surgery is done on a very young child, they may require surgery at a later stage again.
• Risk of a general anaesthetic.
• Double vision may occur after the operation. This occurs in less than 1% of people and usually resolve around a week after surgery.
• The squint may recur at a later stage, and another operation may be required.
• In very rare cases, an eye muscle may slip after the surgery. Another operation may be required. 
• As with all surgeries, infection is a risk. Your ophthalmologist will prescribe eye drops to reduce the risk of infection. 

Does it take long to recover from squint surgery?

Recovery from squint surgery is relatively short. Patients don’t need to wear a patch or bandage at home, and can return to normal activities as soon as they feel ready to. 

Children should ideally be booked off school for a week to avoid infection. Adults should be able to drive the day after surgery (unless they are experiencing double vision). Chat to your ophthalmologist for their recommendations. 

The eye may feel scratchy, and appear red for a few weeks following the surgery while the stitches absorb. Any discomfort can be treated with over-the-counter painkillers. 

Your surgeon will recommend that you: 

• Avoid sports for two weeks
• Avoid contact sports (like rugby) for a month
• Avoid swimming for a month