Written by: Prof. Kent Caslo, Professional Director of ELIA, Developmental Optometrist.
What is squinting:
Strabismus is a condition in which two eyes are not aimed at the same target. There will always be one eye focused on the purpose of the vision but the other eye will not. Most strabismus cases are in the horizontal plane (horizontal) with the squinting eye directed either inward (isotropy) or outward (exotropy).
In rarer cases, the squint is vertical when the squinting eye is up or down.

The vast majority of early strabismus cases are of internal strabismus, where usually the problem is an imbalance in the actions of the eye muscles. Sometimes the cause of internal strabismus is farsightedness. In farsightedness it takes extra effort to see clearly, especially in near vision. This overexertion of the eye causes internal squinting. In these cases glasses can help or solve the problem of strabismus.
Types of strabismus:

  1. Fixed squinting: Squinting can be fixed in one eye, so that one eye is always aimed correctly and the other eye is always squinting. When there is constant squinting the brain ignores the vision of the squinting eye (because it interferes) and then the connection between the brain and that eye will be damaged – causing a phenomenon known as lazy eye . Therefore, although squinting and lazy eye are different symptoms, there is a connection between them.
  2. Intermittent squinting: Intermittent squinting will always have squinting but the correct aiming eye is not fixed and can be replaced.
  3. Transient squinting: There is also the possibility of non-permanent squinting when squinting exists only part of the time.
  4. Simulated squinting: There is another phenomenon known as simulated squinting. In fact there is no squint here but only the appearance of squint. This happens when a baby’s undeveloped (sunken) bridge of the nose causes the skin of the upper eyelid to protect more than the white of one eye compared to the other and this makes us think the colored part is more inward. Only a professional can distinguish between squinting and simulated squinting.

As already mentioned, one of the consequences can be damage to the vision of the squinting eye – and the formation of a lazy eye. In addition, since the two eyes do not work together, there may be damage to the depth diagnosis and three-dimensional vision, and since the brain ignores one eye, there is also damage to the field of vision (peripheral vision) belonging to the same eye. Therefore there may be difficulty in spatial orientation and orientation due to the damage to peripheral vision.
Treating strabismus and the squinting baby:
Treatments for strabismus include strabismus surgery, eye exercises, use of a bandage and visomotor work such as throwing and catching a ball, threading beads and more.
The work and ways of learning and adjustments in the environment for a toddler or child with a visual impairment will include the use of contrasts, appropriate lighting conditions, and practice on spatial orientation – distinguishing in working with the child between familiar and unfamiliar places, shaded versus bright places. There is also a need for enrichment and learning of concepts of depth and distance estimation. We practice routes with different depths and heights, practice transitions between surfaces, marking stairs and more
Close-up depth vision – hand distance – relies mainly on the use of two eyes together. Inserting objects into boxes with different depths, the ovaries, (it is better that the child does not hold both the object and the tool that they are trying to insert or thread the object in, but only the object) Wooden puzzle, hand-eye coordination, distance estimation ) And more
When using a bandage, it is necessary for appropriate visual stimuli and hand / eye coordination work such as the ovaries, wooden puzzle and more.

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