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Question

My daughter is 2 years old she has had a squint for almost a year. It has been suggested by several specialists that she have the operation to correct it- which means cutting the two relevant muscles on each eye.What concerns me with this solution is that there is no quarantee of success, it automatically fixes both eyes so that in the future should they wish to correct themselves naturally they are unable to do so,and finally i believe the eyes can also lose their ability to refract light because they are restricted in their movement. The added bonus in all of this is that there is still no surety that she does not have to wear glasses in the future and when she gets tired and stressed she will definitely need to wear glasses if in fact the suint has not already come back. So I amm not convinced at all that the surgery suggested is going to really be a solution. I postponed the surgery last month to give us some time to think asbout it and seek alternatives. I went to see a proponent of the Bates method in Brighton last month and he gave us some exercises to do with my daughter with the patch, changing emphasis from on eye to the other etc. At6 the same time I am also going to a cranial osteopath who says he can feel tension and feels he is releasing it bit by bit- but every week the tension appears to have moved elsewhere and as a result nothing really seems to have happened. i feel that the exercises would work if my daughter was older and more receptive. It is very difficult to get her to concerntrate and cooperate for any length of time. Consequently I am getting pressure from all sides to operate. The earlier the operation the better opportunity the eyes will have to work with binocular vision. Can we not dothis without surgery? There is no going back.

(Juliette)

Answer:

Dear Juliette

, Don't worry, you don't really have to decide about surgery that urgently. You can very well have your child operated at age three or four. The most important reason for surgery is copsmetic, although some children indeed may have better preservation of binocular vision when operated at an early age. Much more important is the question whether your child has amblyopia, a lazy eye, and needs patching. Also, you are not explicit about whether your child is farsighted. If she is, she needs glasses to reduce the angle of squint and to enhance vision. Finally, exercises will not help. Although the Bates method does no harm, some children start skipping the regular checkups by their orthoptists resulting, for instance, in untreated amblyopia.

Yours truly,

(Herb Simonsz, MD, PhD)

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