Sight is one of the most important senses for a child. The ability to see allows the child to explore, connect and learn safely in different surroundings. Besides having to wear glasses, there are other eye conditions, if left untreated which will seriously affect a child’s ability to see, which will interfere with their physical and mental development. One of these common eye conditions is strabismus, or better-known as squint (more well-known in Malay as mata juling). Squint though more commonly found in children, can occur at any age from babies up to the elderly. Squint can be caused by various factors such as muscle weakness, medical conditions such as stroke or even external impact from accidents.
Squint is a condition where the alignment of the eyes is not straight. There are many types of squint ranging from esotropia (eye turned inwards), exotropia (eye turned outwards), vertical squints such as hypertropia (eye turned upwards), hypotropia (eye turned downwards) and even rotational squints (eyes are rotated).
Dr Fiona Chew Lee Min, Consultant Ophthalmologist and Paediatric Ophthalmologist from Sunway Medical Centre Velocity (SMCV) explains that the most common cause of squint is the inability of the eye muscles to pull the eyeball equally, causing them to be too tight or too loose. This then leads to the eye being pulled in one direction or the other, thus creating a misalignment of the eyes. Dr Fiona elaborates that there are three ways to determine if a person has a squint.
Firstly, we look at the person to see if the eyes are straight – if they are not then the person has a squint. Secondly, we can look at the person’s head to see if it is turned left or right naturally or abnormal while walking. Third, have a close look at the person’s face. If one side is clearly more developed than the other, it is a sign of squint as well, - she says.
Previously squint was thought to be untreatable after childhood. Scientific research and surgical advances have shown that the human brain is elastic and adaptable and even older children and adults all the way to the elderly with squint can be treated. The most important thing is to seek treatment early the minute the squint is noticeable or disrupts normal visual function. Dr Fiona also advises patients to address the issue as early as possible to get the best possible results.
“Squint treatment actually changes a person’s life. Children with squint have reduced or no three-dimensional vision. This means they are unable to judge distances. Also, their visual field is reduced, and they may have delayed developmental milestones. They are more likely to trip over things, face difficulty going downstairs, have problems crossing the road and also have problems studying due to reduced vision and poor concentration.
“Also, because their outward appearance is abnormal, these children may also develop depression, reduced self-esteem as well as being anti-social. Later in life, this will also affect their career prospects. If treated properly, a patient with squint will have improved three-dimensional vision, enhanced concentration and better vision. Career prospects will also improve as they look like normal individuals,” she stresses.
The parents of one of Dr Fiona’s patients, 9-year-old Mia Syuhada binti Sabdani can attest to the life-changing effects of squint surgery. In December 2020, SMCV ran a CSR project titled ‘A Little Wish, For Your Little One’ to fulfil a child’s surgical need. Ramadiah Binti Abd Rahman, Mia’s mother, took the opportunity to seek help for her daughter, who had been experiencing exotropia squint several years prior. The family’s story of struggle, both mentally and financially touched the hearts of all at SMCV and they were then awarded with the opportunity to help Mia.
“We noticed the squint in Mia when she was about 6-years-old and began going to school. Unfortunately, she was teased by her peers in school, found it difficult to concentrate and thus could not pick up on her lessons in the classroom,” she recalls. “Now that she’s a little older, we realised we needed to correct this issue.”
Ramadiah noted that as parents, they were mostly concerned about how the surgery would affect the child, and if there would be any major side effects that would disrupt her eyesight. However, they were very comforted by Dr Fiona’s detailed analysis and explanation about the procedure.
“After the surgery, there was a marked improvement in Mia. Her eyesight has improved – she is now able to focus on learning, reading and writing, and she no longer receives remarks from her schoolmates which in return has helped improve her self-esteem. We are very satisfied with the results of the surgery and are so glad we were able to help our child in this way,” she adds.
Surgery is only one of the many treatments that patients with squint can undertake to correct their condition. Dr Fiona notes that there are various lifestyle modifications that can be carried out to treat it as well.
“Reducing time on electronic gadgets, spending more time outdoors, wearing special spectacles or carrying out regular special exercises can also help improve squint control. Squint can appear at any age from the young all the way to the elderly. It does not matter when the squint appears, as many squints can be treated. Do not be afraid to see your eye doctor – the sooner you get it treated, the better the results,” she says.
