Strabismus (Squint)

What is strabismus?

Strabismus means the eyes are not aligned in the same direction. It affects about 4% of children and can also occur in adults. Eye position usually settles by around three months; a squint noticed after this, tilting the head to look, or closing one eye in sunlight should be assessed. A squint can sometimes be a sign of cataract, a tumour or a neurological condition.

Will my child grow out of it?

A true squint does not resolve on its own with growth. In children with a wide nasal bridge, the eyes may look misaligned when they are not (pseudo-squint); an eye doctor can tell the two apart. If there is a family history of squint or lazy eye, the child should be examined at around one year of age.

Examination and risk factors

Vision is measured in each eye separately; in babies, automated vision screening devices make measurement easier. Risk factors:

• Family history of squint
• Premature birth, low birth weight
• A difference in prescription between the eyes, high long-sightedness
• Cerebral palsy, hydrocephalus

Lazy eye and treatment

In lazy eye (amblyopia), which often accompanies squint, the eye looks structurally normal but did not develop normal vision in childhood, and glasses alone cannot correct it.

• First, any refractive error is corrected with glasses.
• Lazy eye, if present, is treated.
• If the squint persists, surgery is planned; glasses and patching may still be needed afterwards.

Early treatment is more successful; surgery can also be performed in adulthood.