Squint (strabismus) in babies and children

When does a squint matter in babies?

In a newborn, vision is still developing, and brief, occasional squinting can be seen in the first months. If the squint is constant or continues beyond the first months, an eye examination is needed.

Causes of squint

As a general rule, the eye that does not see well is the one that turns. The main causes are:

• Long-sightedness (hyperopia): The most common cause; an eye that sees blurred can become lazy and turn.
• Other refractive errors: short-sightedness, astigmatism
• Congenital cataract and eye tumours: Can cause a white reflection in the pupil (white reflex).
• Eye muscle and visual brain disorders, some syndromes

If the pupil looks white in photos, an examination is needed without delay. Lazy eye can also develop without a squint.

Treatment

• First, a detailed eye examination identifies the cause.
• If the squint is due to a refractive error, glasses are given, and patching is used if there is a lazy eye. Some squints are corrected by glasses alone.
• If the squint persists despite glasses, or there is a structural cause, surgery is planned; lazy eye is usually treated first.

Because vision keeps developing until about the age of nine, early diagnosis matters.