Convergent or Divergent Squint; Double Vision; Prism Glasses

Squint is the condition when the eyes are not aligned on the same visual object simultaneously: otherwise know as a “turn” or “cock-eyed” or “wall-eyed”. Sometimes the squint is constantly present, and others are intermittently present or present only at certain angles of viewing. The medical term for squint is Strabismus. There are many many different causes, e.g. infantile or childhood squint which may be inherited from a parent, or due to an undetected need for glasses at an early age; or a very poorly sighted eye, or a sign of some significant disease within one or both eyes. It is always abnormal to have a squint in a child and this always needs investigated by a paediatric eye team. A Children’s hospital eye department is set up to accurately assess and treat baby and children’s eyes, including accurate prescription of glasses. Adults can have squints for the same reasons. Often a squint reappears in adulthood (usually in the other direction) despite successful realignment surgery many years ago in childhood. Despite perhaps being told that “no further surgery is possible” in the past, this is now very rarely the case: modern surgical techniques have great results in realigning adult eyes nowadays. It is now recognised beyond doubt that it is important to have “straight eyes” in order to build relationships and “get on” in life through education and employment, and in general social interaction.

Squint surgery

I specialise in dealing with adult and childhood squints, and will discuss options after a detailed medical ophthalmic and orthoptic assessment. Surgery on adults and some children can be performed using adjustable suture techniques: almost always as a day case and under general anaesthetic; or botulinum toxin can be used as a therapy or diagnostic procedure. NHS orthoptic colleagues will assess your squint in detail, which I can arrange after seeing and examining you. Sometimes squint can be helped with glasses or prism glasses. Occasionally squints, particularly adult recent-onset type with double vision, will require further investigation; blood-tests or occasionally neuroimaging (MRI or CT scan) and these can be arranged rapidly and easily at Albyn. Whilst surgery often means the eyes are sore a for a few days and red for some weeks,the results are excellent and adult patients are often discharged after a second post-op appointment at 3 months. Children require regular follow-up until the age of around 7.

Things to know

I am sorry than Albyn currently (2016) does not see children younger than 3 due to new hospital regulations. If a private assessment is requested, I suggest Glasgow or Edinburgh as alternatives. However I am delighted to see 3 year old children and over at Albyn; and of course children of any age are seen at the NHS Children’s Hospital. Squint assessment may require an NHS Orthoptist to see you too; I can usually arrange this usually within a few weeks of seeing you at Albyn. Young children will need to be seen in the Children’s Hospital Orthoptic dept, and whilst I can perform an assessment quickly at Albyn, regular Orthoptic follow-up is usually arranged on the NHS at present. Often different dilating eyedrops are used as part of the initial medical assessment of squint: these take 30 minutes to work properly so please be prepared for a lengthier appointment at the Albyn, and, if an adult, please arrange transport home in order to avoid driving.