1. ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology DEPARTMENT OF COUNSELLING Strabismus

2. Strabismus is defined as misalignment of eyes. It is caused by a lack of coordination between the two eyes. Hence the eyes look in different directions and do not focus on the same object Definition for Strabismus (Squint)

3.   Hereditary   Problems with the muscle or nerves that central eye movements   Due to poor vision (eg) Refractive error, Cataract and Injuries Causes

4.  Eye is turned in, out, up or down  It may be constant (or) intermittent  The eye may not move together  The child may complaint of double vision, if the squint occurs suddenly but for adult squint develops late in life Symptoms

5.  The vision in the deviated eye decreases. This is called amblyopia or lazy eye. It occurs because the brain ignores the image / information sent to it by the deviated eye  Since both eyes are not used together at the same time, the child loses the sense of depth perception Vision loss due to Squint

6. Treatment All of the treatment depends up on the cause Refractive errors: Use of correct spectacles, if the vision is low and child has a refractive error. Glass alone may align the eyes in certain cases Amblyopia Treatment of the lazy eye by using glasses and patching the good eye Cont….

7. Cataract: Cataract removal is must for the children's Muscles Problem:  The eye muscle are weakened or strengthened to re align the eye  Some cases require shifting of the muscle to a new position

8. The counsellor should explain the  The cause of squint into the child  How squint affects vision, appearance and academic performance of the child  Creating awareness of the squint  Importance of using glass and patching to improve vision if there is amblyopia Cont… Role of Counsellor

9.  Tell the parents not get discouraged by hearing other’s comments  Counsel about surgery  Moderate the parent’s expectations  Surgery will only make the eyes straight but will not improve or decrease the vision  But for paediatric patient after squint surgery we are doing patching so vision improvement is there (below 0 – 10 years)

10. Importance of follow up  To check vision  To detect change in glass power  To diagnose recurrence of squint  And also improvement of the patching