Squint Surgery in Gurgaon — Expert Strabismus & Lazy Eye Treatment by Squint Specialist Dr. Parul Sony
Has your child's teacher mentioned that one eye seems to wander? Has your paediatrician noticed the eyes aren't quite aligned? Or have you simply noticed something doesn't look quite right in your child's gaze — even though they seem perfectly happy and unaware? If so, you are not alone, and you have come to the right place.
Squint (strabismus) is one of the most common eye conditions in children, affecting approximately 4% of the population in India. When detected and treated early — ideally before the age of 6 — the outcomes are excellent. When left untreated, squint causes amblyopia (lazy eye), permanent loss of binocular vision, and in some children, a lifelong inability to judge depth or see three-dimensionally. The earlier you act, the more completely a child's visual system can recover.
At Complete Eye Care, Gurgaon, our squint specialist is Dr. Parul Sony — MD trained at AIIMS New Delhi and FRCS qualified from the Royal Colleges of Surgeons, UK. With 25+ years of experience treating squint in both children and adults, Dr. Sony and her team offer the complete spectrum of squint care: spectacles, patching therapy for amblyopia, botulinum toxin (Botox) injection, and surgical correction when required. Every child who comes to us is treated as an individual — not as a case type.
What is a Squint? — Understanding Why Eye Alignment Matters
A squint — known medically as strabismus — is a condition in which the two eyes do not point in the same direction at the same time. While one eye looks straight ahead at the object of interest, the other eye deviates — turning inward, outward, upward, or downward. The deviation may be constant (present at all times) or intermittent (appearing only under certain conditions, such as when the child is tired, unwell, or concentrating hard on something close).
In a healthy visual system, both eyes work together as a coordinated team. Each eye sends a slightly different image to the brain, and the brain combines these two images into a single, three-dimensional picture. This is called binocular vision and stereopsis (depth perception). It is what allows us to judge distances accurately — to pour liquid into a glass, catch a ball, or drive.
In a child with a squint, the two eyes send different images to the brain simultaneously. The brain, unable to fuse two mismatched images, faces a choice. In adults, this mismatch causes double vision (diplopia), which is extremely uncomfortable. In children, however, the developing brain takes a different approach — it begins to suppress (ignore) the image coming from the squinting eye. This suppression protects the child from double vision but comes at a serious cost: the suppressed eye begins to lose visual sharpness. This is amblyopia — commonly called lazy eye — and it is the most serious consequence of untreated squint in childhood.
Amblyopia is not a problem with the eye itself. The eye is structurally normal. The problem is in the brain's visual pathways, which have not developed fully because the eye was suppressed during the critical period of visual development (birth to approximately age 7–9). If amblyopia is not treated during this critical window, the visual loss becomes permanent — no glasses, no surgery, and no treatment can fully reverse it once the critical period has closed.
This is why early detection and treatment of squint matters enormously. Not because a squint looks unusual — though some children do experience social difficulties because of it — but because an untreated squint in a young child almost always leads to avoidable, permanent vision loss in that eye.
What Causes Squint in Children and Adults?
There is rarely a single, identifiable cause for a squint — most cases result from a combination of factors. Understanding why squint occurs helps parents appreciate that it is not caused by anything they did or failed to do.
Refractive errors (uncorrected vision problems): The most common cause of squint in children, particularly esotropia (inward-turning squint), is significant farsightedness (hyperopia). When a farsighted child tries to focus — especially on near objects — the focusing effort required can trigger the eyes to converge inward. This type of squint (accommodative esotropia) can often be fully corrected or significantly improved simply by prescribing the right glasses. This is precisely why every child suspected of having a squint must have a proper refraction done before any surgical decision is made.
Muscle imbalance: Six muscles control each eye's movement in all directions. If these muscles are not pulling with equal force — whether due to abnormal attachment, weakness, or overaction — the eyes will not stay aligned. Muscle imbalance is the most direct physical cause of strabismus and is what surgery addresses.
Neurological conditions: The brain controls the six muscles of each eye through three cranial nerves. Damage to or palsy of any of these nerves — whether from birth, infection, trauma, or tumour — can cause a specific type of squint called paralytic strabismus. This is why a new-onset squint in an adult or older child always warrants neurological investigation.
Genetic predisposition: Squint runs in families. If a parent, sibling, or grandparent had a squint, the child's risk is significantly higher than the general population. However, the inheritance pattern is not simple — having a family history of squint does not guarantee a child will develop one, and many squinting children have no family history at all.
Premature birth: Premature infants have a significantly higher risk of squint and amblyopia compared to full-term babies. This is related to immature visual system development at the time of birth and the higher rate of associated neurological and visual problems in premature infants.
Systemic and neurological conditions: Conditions including cerebral palsy, Down syndrome, hydrocephalus, and brain tumours carry a higher association with squint. Children with these conditions should be screened for squint and amblyopia as a routine part of their management.
Squint in adults: In adults, a new squint is more likely to result from a decompensated childhood squint (a previously well-controlled squint that breaks down with age or illness), thyroid eye disease (Graves' ophthalmopathy), nerve palsy, trauma, or neurological conditions. A new-onset squint in an adult always warrants a full medical and neurological workup.
Types of Squint — Which Direction Does the Eye Turn?
Squints are classified primarily by the direction in which the deviating eye turns. Each type has different associations, different causes, and sometimes different surgical approaches.
Esotropia — Inward Turning (Crossed Eyes)
Esotropia is the most common squint type in young children. The deviating eye turns toward the nose. It can be present from birth (infantile esotropia), develop in toddlers due to uncorrected farsightedness (accommodative esotropia), or appear in older children and adults from various causes. Accommodative esotropia — caused by hyperopia — responds well to glasses alone in many cases. Infantile esotropia typically requires early surgical correction to establish binocular vision development.
Exotropia — Outward Turning (Wall Eyes)
In exotropia, the deviating eye turns away from the nose. It is often intermittent in young children — appearing mainly when the child is tired, daydreaming, or in bright sunlight — and can be easily missed by parents who only see it occasionally. Intermittent exotropia can initially be managed with glasses and observation; surgical correction is recommended when the deviation becomes more constant or starts affecting binocular vision development.
Hypertropia — Upward Turning
One eye deviates upward relative to the other. This can result from superior oblique or inferior rectus muscle weakness or palsy. May present with a characteristic head tilt as the child unconsciously compensates for the misalignment. Careful surgical planning is required.
Hypotropia — Downward Turning
One eye deviates downward. Often associated with nerve or muscle palsy. May occur following orbital trauma.
Congenital vs Acquired
A congenital squint is present from birth or develops within the first 6 months of life — the term does not always mean it was present at the moment of birth. An acquired squint develops later and always warrants investigation for an underlying cause, particularly in adults where a new-onset squint may indicate neurological or systemic disease.
Comitant vs Incomitant
A comitant squint has the same angle of deviation in all directions of gaze — the misalignment is the same regardless of where the eyes are looking. An incomitant (paralytic) squint varies in different directions of gaze, with the deviation being larger in the direction of action of the affected muscle. This distinction is important for surgical planning at Complete Eye Care, Gurgaon.
Signs of Squint in Children — What Parents Should Watch For
Many parents miss the early signs of squint because the deviation can be subtle, intermittent, or misattributed to the child "just being tired." Knowing what to look for — and acting on it promptly — can make the difference between excellent outcomes and permanent vision loss.
Signs in infants and toddlers (birth to 3 years):
● One or both eyes appear to turn inward, outward, or at an unusual angle — even occasionally
● The baby does not appear to follow your face or a moving object equally with both eyes
● One eye consistently closes or squints in bright sunlight (a sign of intermittent exotropia)
● The child seems to tilt their head to one side when looking at objects — this is often a compensatory mechanism for a vertical squint or nerve palsy
● Asymmetric corneal light reflex — when a light is shone at the eyes, the reflection does not fall at the same point in each eye
Signs in older children (3 to 12 years):
● Complaints of double vision or "seeing two of things" — though many children with squint do not complain of double vision because their brain has already learned to suppress one eye
● Difficulty with reading, writing, or schoolwork — poor depth perception makes many tasks harder
● Closing or covering one eye when watching television or in bright light
● Visible misalignment of the eyes in photographs — especially in flash photos where the squint is often most apparent
● Clumsiness, poor ball-catching, or difficulty judging distances — these can indicate reduced depth perception from suppressed binocular vision
● Frequent headaches or eye strain, especially after near work
Signs of amblyopia (lazy eye) in a child with squint:
● The child strongly resists having one eye covered — this is a very telling sign. If covering the "good" eye produces no complaint but covering the other eye causes protest, the covered eye likely has reduced vision.
● Consistently poor performance on vision screening tests in one eye
● Difficulty with activities that require fine depth perception
Squint in adults:
● Sudden onset of double vision — always investigate urgently
● Noticeable eye misalignment in the mirror or photographs
● Eye strain or headaches when trying to fuse the two images
● Recurrence of a childhood squint
Lazy Eye (Amblyopia) Treatment in Gurgaon — What Every Parent Needs to Know
Amblyopia — commonly known as lazy eye — is the single most important reason to act quickly when a squint or any other significant eye condition is identified in a child. It is the most common cause of reduced vision in children and young adults in India.
Amblyopia occurs when the brain, during its critical period of visual development, does not receive clear, equal visual input from both eyes. The most common cause is squint — the brain suppresses the image from the squinting eye. Other causes include significant unequal refractive errors between the two eyes (anisometropic amblyopia) and conditions that physically obstruct vision in one eye, such as congenital cataract or ptosis (drooping eyelid).
The crucial facts about amblyopia that every parent must understand:
1. Amblyopia is invisible on casual inspection. The eye looks completely normal. There is no redness, no cloudiness, no visible problem. Your child will not complain of poor vision in one eye because they have never known anything different — to them, this is simply how they see. The only way to diagnose amblyopia is through formal vision testing of each eye separately.
2. Amblyopia is not a problem with the eye itself. The eye, if examined, is structurally normal. The problem is in the brain's visual cortex, which has not developed full visual processing capability for the amblyopic eye because it was not given adequate visual stimulus during the critical period.
3. The treatment window is limited. Amblyopia can be fully reversed if treated during the visual critical period — most effectively before age 7, with diminishing effectiveness from 7–12, and essentially untreatable after the mid-teens. After the critical period closes, no surgery, no glasses, and no medication can restore the full visual potential of an amblyopic eye.
4. Treatment is simple but requires consistency. Patching the better eye for prescribed hours each day is the primary treatment. It is unglamorous, requires persistent commitment from parents and child, and takes months. But it works — the earlier it starts and the more consistently it is applied, the better the outcome.
At Complete Eye Care, Gurgaon, amblyopia management is an integral part of every squint treatment plan. Dr. Sony prescribes a precise patching schedule based on the severity of amblyopia and the child's age, monitors progress with visual acuity testing at every visit, and adjusts treatment when needed. We also provide guidance and encouragement to families — because we know that keeping a four-year-old in an eye patch is one of the most challenging things a parent faces.
Squint Specialist in Gurgaon — Dr. Parul Sony, MD AIIMS & FRCS
When parents search for a squint specialist in Gurgaon, they are not just looking for someone who performs the procedure — they are looking for someone they can trust with their child's eyes. The eyes of a child are not a place for guesswork or limited experience.
Dr. Parul Sony is the Medical Director and founder of Complete Eye Care, Gurgaon. She completed her MD (Ophthalmology) at the Rajendra Prasad Centre for Ophthalmic Sciences at AIIMS New Delhi — where she received extensive training in paediatric ophthalmology, strabismus, and amblyopia management. She subsequently obtained the FRCS from the Royal Colleges of Surgeons, UK — a qualification that reflects the highest international standard of surgical competence.
Over 25+ years in practice, Dr. Sony has built one of Gurgaon's most respected squint programmes. She treats paediatric and adult squint, manages complex paralytic and restrictive strabismus, performs adjustable suture surgery for adult cases, and supervises every amblyopia patching programme personally. The management of squint in children is not purely surgical — it is a carefully choreographed, time-sensitive combination of refraction, patching, monitoring, and surgery at exactly the right moment. Dr. Sony brings this full clinical picture to every patient.
