A 6-year-old girl has squint that is difficult to recognize

A 6-year-old girl has squint that is difficult to recognize

Ho Chi Minh City Baby Ngoc's eyes (6 years old) sometimes deviated outward and then quickly returned to normal, so the family did not notice anything unusual. Now the doctor diagnosed unstable external strabismus.

Associate Professor, Dr. Nguyen Thi Thu Hien, Head of the Department of Refraction, Tam Anh High-Tech Eye Center, Tam Anh General Hospital in Hanoi, explained that Ngoc's case is that cross-eyes are not permanent but appear from time to time. When children are alert and focused, their eyes can still maintain alignment, making it difficult for family members to recognize them. On the contrary, when tired, sleepy, distracted or looking far away, vision ability declines, making the eyes easily deviate outward.

The results of measuring strabismus with a specialized prism showed that the two eyes were squinted at 30 degrees of clear base prism (equivalent to 15 degrees of strabismus). The results of the oculomotor examination showed that the child had V-shaped syndrome - a form of eye movement disorder, the eyes tend to squint more when looking up than when looking down. This abnormality is due to hyperactivity disorder of the lower oblique muscle.

After consultation, the team decided to perform strabismus surgery on both children's eyes. Associate Professor Hien assessed that this case was complicated because it required both surgery to correct external strabismus and intervention to treat lower oblique muscle overactivity, requiring high accuracy in calculating the degree of eye muscle correction.

After completing preoperative testing and anesthesia assessment, the child is operated on under laryngeal mask anesthesia. Doctors simultaneously retracted the external rectus muscle and lower oblique muscle in both eyes to correct external strabismus and lower oblique muscle hyperactivity, overcoming V-shaped syndrome. The surgery took about 35 minutes, the patient was awake, recovered quickly, and was discharged the same day.

Strabismus is not always present continuously, so it is easy to ignore. If a child often shows signs of deviating eyes, especially when tired, looking far away or losing focus, an eye specialist needs to be examined to confirm the diagnosis of strabismus, measure strabismus, evaluate binocular visual function and periodically monitor. Detection and treatment at the right time helps increase the ability to preserve binocular vision, limit the risk of deterioration of visual function and improve post-operative effectiveness.

Hoang Duong

*Patient's name has been changed