What could cause a 4-month-old child's eyes to drift?

Question

Hello doctor,

My four months old son seems to have an eye that drifts outward occasionally. He has been seen by a pediatric ophthalmologist when he was two months old. The doctor told us that, my son has normal infant vision. The doctor suggested to come for a review after a month to see the eye alignment and the doctor told me that this is just normal eye misalignment typically seen in very young babies. A week later, I noticed his eye drift was reduced. Now there is a lot of change in his behavior and he has also started doing a lot of new things like laughing, sitting upright, and holding his head up, and also gained weight on his legs. I have noticed the eye drift most when he looks to the left and when looking into the distance. I am wondering if he is likely to outgrow this condition. What are the treatment indications for a baby this young? Please help me.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your query. Your kid definitely has a squint. This is not a normal thing. The first step in the management of squint is cycloplegic refraction under Atropine (0.5 mg monohydrate atropine sulfate, equivalent to 0.415 mg atropine. Consult a local pediatric ophthalmologist and he will do the refraction and he will prescribe glasses if required. The doctor has to make sure the child does not develop amblyopia. As amblyopia is very common in a squint. So request your doctor to check his visual activity with TAC (teller acuity cards). If amblyopia is suspected, then the doctor has to start occlusion therapy. The next step is to evaluate the type and amount of squint and after confirmation, the doctor may need to operate if required. I hope I cleared your doubt. Thanks and regards.