Q: I have a 10 months old baby. He was born a month premature because the cord was around his neck. Since his birth weight (2.75 kg) was good, there was no problem. Now, the problem is that he has a squint. We consulted an eye specialist in India who said that baby has a squint and should be treated. At present we are in Singapore and consulted doctors here who said there is no apparent squint. There is only a slight deviation sometimes. Should we consult an eye specialist? There are no, paediatric ophthalmologists here. Can this be treated or my baby has to live with it? When does surgery become essential? Is surgery necessary for slight deviation too? Is there any other alternative for making the muscles strong? Should we go for naturopathy treatment?

A:What I want you to know that squint itself is not a disease but a manifestation of some other problem commonest of which is substandard vision due to any cause. This causes the brain to concentrate on the better of the two eyes and the other eye becomes poorer which is also called lazy eye (amblyopia) and squint develops. First priority should be to assess the vision of each eye separately. The eye specialist will put some eye drops to dilate the pupils, which not only gives a better view of inside and back of the eyes but also paralyses the muscles of the eyes enabling him to decide whether the child needs any glasses and of what power. If there is a need for glasses, this itself will correct vision and most of the squint and also rule out any other defect. If the lazy eye has developed, the eye specialist will recommend, patching of the good eye to force the lazy eye to improve which may take 3 months or longer. Only when there is no more improvement possible, the specialist will recommend surgery to correct squint, if there is any. This is usually not a serious condition and you need not worry about it too much. Age for surgery can be upto 5-6 years. But sooner the better. In some children, the bridge of the nose is too wide which may give you the impression of squint when there is no squint- this is called pseudo squint and does get better on its own when the child grows up. There is no other way or naturopathy to treat this condition. Most ophthalmologists should be able to deal with it. You don't necessarily need a paediatric ophthalmologist.