What is a squint?
A squint (or strabismus) is where the eyes are out of alignment and do not work together. One eye looks straight ahead while the other may turn in, out, up or down, or a combination.
A squint may be present all the time (constant) or only at certain times (intermittent).
A squint may be present from birth (congenital or infantile) or may develop later (acquired).
How common is a squint?
A squint is a common condition and affects 5% (1 in 20) children in the UK.
A squint usually develops before the age of 5 years, but may occur later.
What causes a squint?
Often there is no obvious reason for a squint to develop.
Family history of squint or glasses in childhood is significant.
The most common cause of an in -turning (convergent) squint is the need for glasses to correct long-sight (hypermetropia).
Rarely there may be a problem with a nerve or an abnormally developed eye muscle.
Babies born prematurely or children with significant health problems are more at risk.
Will my child grow out of their squint?
No, although there may be changes over time. Your child will have their eye position and vision monitored regularly in the eye department.
A squint may be more noticeable when your child is tired or unwell. A squint may also vary in size and frequency day to day, particularly if it turns outwards (divergent).
Some very young babies have an occasional squint which is quite normal as the brain learns how to make the eyes work together. If this persists beyond six months of age then your baby should be referred to an eye specialist.
How will a squint affect my child?
Amblyopia (lazy eye)
Amblyopia (lazy eye) may occur in the squinting eye. This is when sight does not develop properly in the affected eye because the necessary connections in the brain are not made.
Loss of stereoscopic vision (3-D vision)
If the squint is intermittent then your child may have 3-D vision at times. If a squint is present from birth or is constant then your child will not have 3-D vision. They will adapt to using one eye at a time and will learn to judge distances using other clues.
Diplopia (double vision)
This is very unusual in children as normally the brain learns to “switch off” from the squinting eye. Your child may complain of seeing double when they are very tired or performing certain tasks. If your child mentions this to you then let your Orthoptist know.
Abnormal head position
If your child’s squint is caused by a nerve or muscle problem then they may adopt an unusual head position to try to bring the eyes back into alignment.
Cosmetic appearance
Generally young children are not conscious of a squint although they may become more aware as they get older.
What treatment might my child need?
Glasses
Your child will be tested (refracted) to see if they require glasses. If prescribed, these will help the sight to develop and in some cases may help to control or improve the alignment of the eyes. Not all children with a squint will require glasses.
Amblyopia treatment
If your child has developed a “lazy eye” where one eye sees better than the other, then patching or eye drops may be recommended to improve the sight of the squinting eye. The sight will need to be regularly monitored. (See information leaflets “What is Amblyopia?” and “Treatment of Amblyopia”).
Treatment for amblyopia does NOT improve the squint itself but is a vital part of treatment of your child’s eye condition.
Surgery
The Ophthalmologist will advise as to whether surgery might help your child. Not all squints can be corrected by surgery. The eye muscles are weakened or strengthened so that the eyes appear straighter or to help them work together as a pair. Occasionally surgery may help to improve an abnormal head position.
If your child requires glasses to help them see then glasses would still need to be worn after the surgery.
Eye exercises
Only certain types of squint can be treated with eye exercises. Your orthoptist will advise you.
Special lenses
Some types of squint may be treated using special lenses or bifocals to help relax or stimulate the focusing. This may improve the alignment of the eyes but is not generally a long- term solution.
Prisms
These are only occasionally used in children.
How long will my child need to attend the eye department?
This will vary depending on the type of squint that your child has and what treatment is required. Most children are discharged by the age of 7 years as treatment for lazy eye (amblyopia) is rarely continued beyond this age. Your child may be discharged sooner if their squint and vision are stable. If your child wears glasses then a local optician will take over the care of your child’s eyes.
Who will we see at the assessment?
- Orthoptist: an allied health professional (AHP) specialised in diagnosis and treatment of strabismus (squint), binocular vision and eye movement problems. They will measure the squint and supervise any amblyopia (lazy eye) treatment that may be required.
- Optometrist (optician): a specialist trained to detect defects in vision. They will measure the size and shape of the eyes (refraction) and advise on the use of glasses.
- Ophthalmologist: a doctor who is specialised in diagnosing and treating defects, injuries and diseases of the eye. They will look into the back of the eyes to check they are healthy and perform any squint surgery if needed. They will advise on overall treatment of your child’s eye condition.
- Paediatric nurse may be present to assist during your child’s appointment with the doctor.
- Nursery Nurse may assist the eye care team with assessments and provide face to face or telephone support with your child’s treatment, particularly wearing glasses or a patch.
For further information
Contact details
Appointments Office
To change or cancel an appointment: 0191 282 4444.
Monday to Friday 9am to 5pm (excluding Bank Holidays)
Orthoptic Department
To speak to an Orthoptist about treatment call: 0191 282 4434
Monday to Friday 9am to 5pm (excluding Bank Holidays)
PALS (Patient Advice and Liaison Service)
For help, advice and information about NHS services. You can contact them on freephone 0800 032 02 02, e-mail northoftynepals@nhct.nhs.uk or text to 07815500015.
If you would like to find accessibility information for our hospitals, please visit https://www.accessable.co.uk
Useful websites
If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS Choices website at www.nhs.uk
Specifically regarding Children’s eye tests:
www.nhs.uk/conditions/eye-tests-in-children/
