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operation, eye, vision, eyes and muscle

SQUINTING (STRABISMUS).—A faulty position of one or both eyes, rendering it impossible for the patient to focus the visual axes of both eyes simultaneously upon one object. While one eye looks at the object, the other looks past it in another direction (see Plate XII. 6). Squinting may be due to paralysis of an ocular muscle, to rheumatism, or to some other affection. The sudden occurrence of double vision often renders it a very annoying condition. That form of squinting which is most frequent during youth may be called forth by any of those causes which, either temporarily or permanently, impair vision. These are : (I) Obstinate inflammation of the eyes, and the consequences due to this affection (such as spots in the cornea) ; (2) unequal strength of vision of the eyes ; and (3) irregularities of refraction (long-sightedness, near-sightedness, etc. ; see SIGHT, DISTURBANCES OF). Inward squint may be due to long-sightedness ; outward squint, to near-sightedness. Squinting usually begins as an intermittent affection, with periods in which vision is normal ; in the course of time, however, it generally becomes permanent. The squinting eye is often weak of vision from birth.

The treatment of squinting is usually attended with success if begun early enough. In many cases, especially the milder ones of youth, the disturbance may be removed by wearing proper glasses (prescribed by a physician) and by systematically exercising the ocular muscles. In the cases of small children who cannot yet wear glasses, it is often sufficient to bandage the healthy eye, thereby forcing the squinting eye to look straight at objects.

If the condition fails to improve in spite of spectacles and eye-exercises, one should not hesitate to have an operation performed (see next paragraph). This is an absolutely harmless procedure, and accomplishes the desired result in almost every instance. It is, however, advisable to wait until the little patient has acquired a certain amount of reasoning powers ; that is, until he is about eight years old. Following the operation, spectacles must be worn in order to prevent a recurrence. Squinting due to diphtheria requires no special treatment ; as a rule, it improves spontaneously step by step with the increased strength of the child.

The operation for squinting is performed in order to restore the equilibrium between the muscles which move the eye outward and inward. The squint is internal or external, according to which muscle is the stronger. In mild cases it is sufficient to separate the stronger muscle from its point of insertion in the eyeball ; in severe cases it may be necessary to place the point of insertion of the weaker muscle more anteriorly. The operation is harmless, as the eyeball is not injured. No scar remains. Complete success may not be attained by the first operation, and, in such cases, a second operation may be necessary. In other cases the effects must be aided by wearing suitable eye-glasses and by exercising the eye-muscles. See also SIGHT. DISTURBANCES OF.