Squint Evaluation

What is Squint Evaluation?

Squint evaluation, also known as a strabismus evaluation, is a comprehensive eye exam to assess the alignment of the eyes and identify any deviations from normal binocular vision. Strabismus is when two eyes are not looking in the same direction. It helps determine if there is a squint (misaligned eyes) and its type, cause, and severity. The evaluation involves both sensory and motor testing to assess how the eyes work together and how they move independently.

Why is the test done?

Early detection and treatment of squint are crucial to prevent amblyopia (lazy eye), preserve binocular vision (both eyes working together), and eliminate double vision (diplopia). Squint evaluation can also help determine what type of squint the patient might have and whether it is constant or intermittent. By pinpointing the type and severity of the squint, the correct treatment can be chosen. Treatment options may include glasses, patching (occlusion therapy), eye exercises, or surgery, depending on the individual’s case.

How is the test done?

History taking: Gathering information about the onset, duration, and any associated symptoms of the squint.
Visual acuity testing: Assessing the sharpness of vision in each eye
Motility testing: The smoothness of the eye's movements when looking at different angles are observed to evaluate the range and coordination of eye movements. This helps identify any restrictions in eye movement related to different muscles
Cover test: A fundamental test where one eye is covered to observe the movement of the uncovered eye when it is uncovered. This helps identify the presence of a manifest squint (tropia) or a latent squint (phoria)
Alternate Cover Test: The cover alternates between both eyes to observe the eyes movement to regain fixation
Corneal light reflex test (Hirschberg test): A light is shone into the eyes and then the reflection of a light source on the cornea is observed to detect any misalignment. This can help determine if the squint is convergent (inward) or divergent (outward)
Sensory testing: Assessing binocular vision, depth perception, and suppression (where one eye's input is ignored)
Angle measurement: Determining the degree of deviation in cases of manifest squint. This may involve using prisms or other specialized instruments
Red flag assessment: Identifying any signs or symptoms that may suggest a more serious underlying condition, such as tumors or neurological issues
Forced Duction: Determines if there is any physical restrain in eye movement
Worth Four-Dot Test: Helps determine if the patient is using both eyes together and if one eye is suppressed
Stereopsis: Assesses the patient's ability to perceive depth

Duration

The duration of Squint Evaluation test will be 35 – 45 minutes

Treatment

The most common and easiest treatment is glasses if the squint is associated with focusing problems. Vision therapy is also an effective option to strengthen the eye muscles to work together again. In very rare cases, surgery may be an option to adjust eye muscles. This depends on the type of squint and the severity.

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