What causes Squint in Children?

I am Dr. Anin Sethi, and today we will talk about squint or strabismus. It is a misalignment of the two eyes where the eyes do not look in the same direction. We previously have done videos on this on our platform SimpliHealth. Today we will talk about what causes squint in children. 

1. The most common cause is a refractive error, which means having glasses. The power of the glasses is of two types, positive and negative. So if the child’s power is positive, he would put a lot of effort into focusing and seeing the environment clear; however, when they put a lot of effort to focus on things, their eye deviate inwards. This is also called esotropia. So to get the power of the glasses for children with esotropia becomes very necessary. If the power of the glasses is negative or cylindrical, he’s losing vision, and he can see blood in his eyes, then the deviation of the eye would be outwards. So that is, the eye would deviate towards the ear. These are the two types of squint that the power of the glasses can cause. So whenever we have a patient who has a squint, the first thing we do is get the power of his glasses checked. 
2. The second most common cause of squint is losing vision. One might not have a clear vision because he needs glasses, but there could be other reasons. For example, the person can have motia bind, some problem in his nerves or the retina. These dysfunctionalities also cause the eye to inward or outward. If the baby is very young, then the eye tends to deviate towards the nose. If the child is a little older, the eye can also deviate outwards, towards the ear.  Loss of vision and the power of the glasses are the most common reasons for squint.
3. The third reason would be developmental reasons. There are different diseases in which the muscles of the eye stop working. For example, due to a lesion on a cranial nerve, the muscles that hold the eye stop working, and the eyes’ alignment is disturbed. So due to these developmental causes, the child has a squint since birth, just like (name), (duane’s name) syndrome, and brown’s down syndrome. We would not go into detail here but, the eye muscles that make the movements deteriorate, which causes the eyes to deviate either inward or outwards. 
4. The fourth category is very rare. When a baby is born and has breathing problems or the blood supply to the brain is damaged, the baby has to be kept in the ICU. All this could’ve caused the underdevelopment of the brain. This may result in the misalignment of the eye in these children. If the structure of the skull and the facial bones is not developed correctly in the womb, it may also cause disbalance in the muscles in the eye. This may also result in misalignment or deviation of the eye. 

So whenever we have a patient complain about squint, the first thing we do is check for the power of the glasses and eyes. Suppose this condition does not improve after getting corrective glasses and trying other therapies. Then, the patient might need surgery.