Convergent Squint

introduction

What is Convergent Squint?

Squint (Strabismus) is misalignment of eyes, where both the eyes do not look in the same direction.

In convergent squint the deviating eye is directed inwards towards the nose; medically termed Esotropia.

Convergent squint Symptoms

  • Noticed by the patient when the patient looks into the mirror or it is noticeable by others.
  • The vision in the squinting eye may be less in some cases as compared to the normal eye. This is colloquially termed as Lazy Eye.

Convergent Squint Causes

  • Squint can be hereditary but not all family members may develop the same type.
  • Untreated far-sightedness: If you are far-sighted and not wearing glasses, constant strain on the eyes can force the eyes into  becoming cross eyed.
  • Premature birth
  • Neurological disorders like hydrocephalus
  • Overactive thyroid gland-Hyperthyroidism
  • Diabetes 
  • Stroke

Convergent Squint Risk Factor

  • Diabetes
  •  Family history
  • Genetic disorders 
  • Hyperthyroidism
  • Neurological disorders
  • Premature birth
prevention

Convergent Squint Prevention

Only in refractive type convergent squint; timely intervention with glasses will prevent further worsening of squint.

Convergent Squint Types

  • Congenital Esotropia: when present at birth or within one year of life
  • Refractive Esotropia: Due to hypermetropia or far-sightedness
  • Acute onset Esotropia: Due to short sightedness and prolonged near work
  • Incomitant Esotropia: Due to neurological disorders; vasculopathy secondary to metabolic disorders
  • Sensory Esotropia: Due to poor vision
  • Esotropia associated with special strabismus like Duane Syndrome

 

Convergent Squint Diagnosis

  • Assessment of vision in each eye
  • Refraction to rule out refractive errors (power): myopia; hypermetropia; astigmatism
  • Assessment of angle of squint for distance and near using prism
  • Assessment of eye movements
  • Assessment of binocular vision and 3D vision
  • Assessment of double vision
  • Complete eye evaluation

 

Convergent Squint Treatment

  • Congenital or infantile esotropia requires surgery or Botox injections into eye muscles
  • Refractive esotropia requires glass prescription; some may need bifocals
  • Acute onset esotropia may require surgery provided MRI brain scan is normal
  • Incomitant esotropia depending on the type, may require surgery; prism glasses or Botox injection
  • Sensory esotropia will require surgery for cosmetic reasons

 

Convergent Squint Complications

  • Loss of vision in one or both eyes
  • Binocular vision problems
  • Double vision; loss of 3 D vision

Written by: Dr. Manjula Jayakumar – Sr. Consultant Ophthalmologist, TTK Road

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