principles of management of non-paralytic squint

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Non-paralytic squint can be managed on several fronts, best remembered by the fact that they all start with an o:

  • optical measures:
    • prescription of spectacles to overcome refractive errors, principally in squint caused by long sight
    • this sharpens retinal images and decreases accommodative convergence

  • orthoptic exercises:
    • performed best by orthoptists where the patient is encouraged to fuse images with the lazy eye

  • occlusion of the better-seeing eye:
    • to force the squinting amblyopic eye to take up fixation and thus improve its level of visual acuity
    • this works best if started at an early age
    • usually requires many hours each day over weeks or months

  • operative correction of the squint

Last reviewed 01/2018