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Squint signs, cataract surgery on both eyes done, intraocular lens and squint removal surgery suggested. Advice?

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Posted on Thu, 7 Jun 2012
Question: Helllo doctor,

My son is 9 months old. He showed signs of squint and then was diagnosed of congenital cataract in both the eyes at the age of 4.5
months. He underwent cataract removal surgery on both eyes. The specs power is +20 on left eye and +21 on right eye. Doctor said after

2.5 years, he can get intraocular lens in both the eyes. Now for the squint (turns both eyes inwards and keeps moving,
supposedly due to lesser fixation achieved because of cataract), doctor has adviced to put patch on both the eyes everyday, 2 hrs each

on right and left eye. We are told squint removal surgery can be performed after the intraoccular implantation, which can be done

after about 2 years. It is very difficult to manage the small baby with the patch, till then for 2.5 years we have to put the patch

everyday. So I just thought of having second opinion, if squint surgery can be done now (9 months old) prior to the intraoccular

implantation and will it help? Are there any other measures we can take to reduce squint in particular and to improve his vision in

general? He seems to be developing vision well as he crawls, picks objects around, identifies all of us at home and loves going and

watching things outdoors, though there is still visible squint.
Please advice me.
Thanks in advance
doctor
Answered by Dr. CS Narayan (25 minutes later)
Hi,

Thanks for your query.
I shall address your concern based on your current given information.

I understand you need help with the timing of eye surgeries of your son.

Cataract surgery and then followed by IOL implantation has one risk that is common. It is squint and diplopia.

Now, your son already has squint - and it would come back once IOL is implanted later, after squint surgery.

Hence, first the eye surgeon does the IOL implantantation first, and thereby any squint or diplopia that is remnant along with the already present squint in the child, would be corrected by the squint surgery that would planned in the end.

Measures to reduce squint in the child ?
Alternative therapy includes botulinum toxin injections, eye exercises.
Now eye exercises are difficult to perform in the infant.
Hence, the importance of surgery.
And botulinum toxin needs your doctor's advice.

Hence, the best options are with padding, glasses and surgery.

I hope I have answered your concern on a broad sense, now.

If you have additional questions regarding these recommendations or further new queries as you prepare to make decision regarding future care, do not hesitate to reply.

Regards,

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. CS Narayan

General & Family Physician

Practicing since :2004

Answered : 546 Questions

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Squint signs, cataract surgery on both eyes done, intraocular lens and squint removal surgery suggested. Advice?

Hi,

Thanks for your query.
I shall address your concern based on your current given information.

I understand you need help with the timing of eye surgeries of your son.

Cataract surgery and then followed by IOL implantation has one risk that is common. It is squint and diplopia.

Now, your son already has squint - and it would come back once IOL is implanted later, after squint surgery.

Hence, first the eye surgeon does the IOL implantantation first, and thereby any squint or diplopia that is remnant along with the already present squint in the child, would be corrected by the squint surgery that would planned in the end.

Measures to reduce squint in the child ?
Alternative therapy includes botulinum toxin injections, eye exercises.
Now eye exercises are difficult to perform in the infant.
Hence, the importance of surgery.
And botulinum toxin needs your doctor's advice.

Hence, the best options are with padding, glasses and surgery.

I hope I have answered your concern on a broad sense, now.

If you have additional questions regarding these recommendations or further new queries as you prepare to make decision regarding future care, do not hesitate to reply.

Regards,