Strabismus (for children)

What is a squint?

Squint is the common name for ‘strabismus’ which is the medical term used to describe eyes that are not pointing in the same direction. A squint can be convergent (esotropia), divergent (exotropia) or vertical.

What are the symptoms of squint?

The most obvious sign of a squint is one eye that does not look straight ahead but turns inwards, outwards, upwards or downwards.

Minor squints may be less obvious.

Babies and young children

It is quite normal for the eyes of newborn babies to ‘cross’ occasionally, particularly when they are tired. Speak to your GP if you notice this happening to your child after the age of three months.If your child looks at you with one eye closed or with their head turned to one side, it may mean that they are experiencing double vision and could be a sign that they have a squint. See your GP as soon as possible if this happens repeatedly.

Lazy eye

If a squint is left untreated, lazy eye (amblyopia) can develop. The vision in the affected eye gradually deteriorates because the brain ignores the weaker message being sent from that eye. It is not usually possible to correct amblyopia after the age of about 7 years, which is why it is so important to treat a squint as soon as possible.

What causes squint?

There are a number of causes. The main ones are:

  • Refractive error (focusing abnormality, particularly uncorrected long-sight)
  • Eye muscle imbalance

These separately or together cause squint.

  • It can run in families
  • Illness – can make it obvious
  • Injury
  • Rarely, it can be due to other diseases or illness

Some babies may appear to have a squint when they do not in fact have a true squint. This is because some small children have a wide bridge to their nose, which makes the eyes appear to be turning in. This is sometimes termed ‘epicanthus’. Epicanthus does not exclude the possibility of a squint being present and so you should always seek an expert opinion if you are concerned.

Treatment for squint

Treatments include glasses and, occasionally, eye exercises. If your child has a lazy eye, they may need to wear an eye patch to improve the vision in the affected eye. Many patients may only need the condition monitoring reqularly.

In some cases, corrective surgery may be undertaken, most commonly to improve the appearance of the eyes, but sometimes to correct double vision or, in young children, to try and develop the co-ordination of the two eyes to work together for 3-D (depth) vision. Occasionally, surgery is done to improve an abnormal position of the head.

Squint surgery is a very common eye operation. It usually involves tightening or moving one or more of the outside eye muscles which move the eye to change the eye position. These muscles are attached quite close to the front of the eye under the conjunctiva, the clear surface layer. The eye is never taken out of the socket during surgery. Stitches are used to attach the muscles in their new positions.

Squint surgery is nearly always a day-case procedure, so you should be in and out of hospital on the same day. There are two kinds of squint operation - adjustable and non-adjustable. In adjustable surgery, which can be performed in older children and adults, the stitches can be adjusted shortly after the surgery, when the patient is awake.

Risks from surgery are rare, but there can be unpredictability in the exact position of the eyes after surgery and sometimes more than one operation will be needed.

Occasionally, squints corrected during childhood reappear in adulthood. You should visit your GP as soon as possible if you develop a new squint.

Frequently asked questions

Is squint common?

About 2-3% of the population have a squint.

Is my child too young to start treatment?

No, the earlier the better.

Does it matter if the squint is not treated?

Yes:

  • If at some later point the sight in the better eye is lost e.g. by accident, the squinting eye could not compensate and your child would be visually handicapped.
  • Your child will NOT grow out of the squint
  • Sight will get worse in the affected eye
  • Your child may be teased about their appearance
  • Your child may be precluded from some jobs later if they have a lazy eye
Should other children be checked for squint?

Yes, because squint can run in families.

Strabismus (for children) treatment is available at Moorfields Private

You can self-fund or use private medical insurance to fund your treatment.

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