qa13

Question

I would like to draw your kind attention for intermittent type of squint. Suppose squint is not permanent and it occurs while looking at distance objects. We can say that squint is intermittent in nature. I want your advice in such caes, What you suggest:
(1) Excercise
(2) Surgery.

(Nilesh Patel)

Answer:

Dear Nilesh,

Thank you for your question. If your divergent squint occurs only when looking in the distance, there are two possibilities (assuming that you have not had surgery, for convergent squint, for instance).
One is that, when looking at near, your eyes are straight and remain straight, even when looking with one eye only, by patching one eye for a day or so.
The other possibility is that, when patching one eye for a day, the divergent squint also starts occurring when looking at near. In that case, apparently, the eyes are kept straight by fusing the images of the two eyes by convergence.
Exercises do not help in either case. Surgery is only permitted in the second case because in the first case you would, by surgery, create convergent squint on looking at near and, as a general rule, changing a divergent squint into a convergent squint or vice versa often leads to double vision.
Most patients are somewhere between the two extremes described above, however. Therefore in most cases some surgery can be done, as long as the patient is not made convergent when looking at near.

(Herb Simonsz, MD, PhD)

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