A squint (or strabismus) is when the eyes are not looking in the same direction. A squint may be noticeable all the time, or it may come and go.
The eyes of newborn babies may sometimes appear to wander or be turned. But, by around 4 months of age, your baby's eyes should be straight and move together in all directions.
Some babies look like they have a squint due to the wide bridge of their nose. As they grow, their features develop and this appearance goes away. But, a child with a true squint will not grow out of it.
When one eye is straight the other may look in or out as in the picture below.
One eye turning inwards (called esotropia) or one eye turning outwards (exotropia).
One eye may also look up (hypertropia) or down (hypotropia)
Children can be born with a squint or develop it in childhood. Often, it's caused by a problem with the muscles that move the eyes, and can run in families.
Sometimes, a child may develop a squint because an eye is abnormal and there is a problem with sight.
See your family doctor if you think your baby or child has a squint.
Children do not outgrow a squint. It's important to start treatment at an early age.
Treatment might include glasses, patching, exercises, or surgery and is usually a combination of these.
Your child will need to see an ophthalmologist (eye specialist) or an orthoptist (specialist in the assessment, diagnosis and treatment of certain eye problems).
The aims of treatment are:
The main complication of a squint is amblyopia. Sometime, people call amblyopia a 'lazy eye'.
When eyes don't line up together, the straight or straighter eye does most of the work. The eye that's not straight doesn't see as it should. It becomes weaker. It's not receiving as clear a picture as the other eye. The part of the brain responsible for vision in that eye also doesn't develop properly. This is called amblyopia.
If left untreated it can lead to very poor vision. After the age of 5 and a half years, it gets more difficult to reverse amblyopia. After 7 years, it is usually impossible.
Amblyopia is the most common cause of poor vision in children.
The most common causes of amblyopia are:
To reverse amblyopia and bring the vision back in the weaker eye, your child's treatment will focus on making their brain use the weaker eye again.
Treatment for amblyopia is patching and/or glasses. When treatment starts at an early age, vision often improves.
Patching or covering the good eye is the most common way of encouraging your child to use the weaker eye.
If your child's treatment includes patching, their eye specialist may recommend patching either:
After a set period, your child will have a vision check.
See the Health Navigator website for tips about patching [1]
Some children need glasses as part of their treatment.
If your child does have glasses, they may be able to wear a patch over one lens.
Illustrations of child with squint by Dr Greta File. Property of KidsHealth.
Photos are from iStock.
This page last reviewed 03 July 2022.
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Links
[1] https://www.healthnavigator.org.nz/health-a-z/a/amblyopia/
[2] https://kidshealth.org.nz/tags/eyes
[3] https://kidshealth.org.nz/contact?from=http%3A%2F%2Fkidshealth.org.nz%2Fprint%2F2714%3Flanguage%3Dko