Squint can be a complex
condition and not every situation is covered here, but we will be pleased to
give further advice, if needed. Children will benefit from support and
encouragement during treatment, therefore, people should not be afraid to ask
questions which will help them understand the condition and treatment. The
successful outcome of treatment depends upon everyone co-operating.
What is a squint and how common is it?
A squint (also
known as a strabismus) is a condition which arises because of an incorrect
balance of the muscles that move the eye, faulty nerve signals to the
muscles and some refractive error (focusing faults). If these are out of
balance, the eye may turn in (converge), turn out (diverge) or sometimes
up. Approximately 5% to 8% of children are affected by a squint or a squint
related condition, which means 1 or 2 in every group of 30 children. If
appears to have a squint at any age from six weeks onwards, it is important
to seek professional advice quickly. Many children with squints have poor
the affected eye.
What causes it?
There are several types of squint. The cause is not always known, but some
children are more likely to develop it than others.
Sometimes a baby is born with a squint, although it may not be obvious for a few
weeks. In about half of such cases, there is a family history of squint or the
need for spectacles. The muscles are usually at fault.
Long sight (hypermetropia)
This can sometimes
lead to a squint developing as the eyes are over-focusing whilst trying
to see clearly. The over-focusing produces double vision.
In an attempt to avoid this, the child may automatically respond by
image from one eye and turning it to avoid using it. If left untreated,
eye" may result. The most common age for this type of squint to
start is between 10 months and 2 years, but it can occur up to the
age of 5 years.
first noticed when a baby is looking at a toy, or at a later age when
a child is
concentrating on close work, such as a jigsaw or reading.
Following an illness such as measles or chickenpox, a squint may develop. This
may mean that a tendency to squint has been present but, prior to the illness,
the child was able to keep his or her eye straight.
In some cases a difficult delivery of a baby or illness damaging a nerve can
lead to a squint.
Can a baby have a squint?
Yes, a baby can
have a squint, especially if there is a family history. If this is suspected,
it is important that the baby be
at the earliest opportunity. Sometimes a baby has what is known
squint" which is related to the shape of the face, but a
baby with a true squint
will NOT grow out of it.
Isn't a squint just a cosmetic problem?
Certainly the appearance can lead to problems for the child, but a squint is not
merely a cosmetic problem. If left untreated, it can lead to a permanent visual
defect in the squinting eye.
How can you tell if a child has a squint?
People often think that they can tell if a child has a squint if their eyes look
different. This is not necessarily a squint. Squints are often difficult to
detect, especially in younger children. Older children may complain of sight
difficulties such as double vision. If it is thought that a child has a squint,
the Health Visitor, Child Health Clinic, GP or school doctor / nurse should be
asked about a referral to an optometrist, ophthalmic medical practitioner or
hospital eye clinic for assessment.
What treatment is available and will an operation always be needed?
No. An operation is not always needed. Treatment varies accordingly to the type
of squint. The main forms of treatment are:
Spectacles: To correct any sight problems, especially long sight.
Occlusion: This is patching the good eye to encourage the weaker eye to be used. This is done under orthoptic supervision.
Eye drops: Certain types of squint can be treated with the use of special eye drops.
Surgery: This is used with congenital squints, together with other forms of treatment in older children, if needed, Surgery can be performed as early as a few months of age.
The College of Optometrists,
42 Craven St, London WC2N 5NG
Tel: +44 (0) 20 7839 6000
Fax: +44 (0) 20 7839 6800