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What is a Squint?

Also known as ‘strabismus’, squint problems are disorders in which the eyes don’t look in exactly the same direction at the same time. One eye looks straight at the object of regard and the other eye points in a different direction. The deviating eye may turn inwards or outwards or it may be directed higher or lower than the other eye. The misalignment means that the eyes cannot work together, and sometimes the person’s eyes will alternate fixation. Squints affect approximately 4% of children and may arise in the first few months of life or appear later in childhood.

What causes a squint?

There are many types of squint. They have a variety of causes and it is common for squints to be multifactorial.

  • Squints often run in families with other family members having had a squint or glasses in childhood.
  • Very occasionally, a child may develop a squint because an eye is abnormal and there is a problem with sight. If a child squints with one eye, the vision in that eye will become lazy. This is because the brain learns to ignore information coming from the squinting eye.
  • In some cases, the cause is unknown.

Problems associated with Squints

In early onset squint, the child will have a poor ability to use the eyes together (known as binocular vision) and the squinting eye will often have poor vision. Left untreated, squints may;

  • cause a child to develop a lazy eye, (poor visual development) which if not corrected will lead to poor sight in that eye – see the section on Amblyopia
  • cause a child to lose binocular vision
  • cause adults to develop double vision
  • affect the cosmetic appearance

The earlier these problems are detected the sooner treatment can be started.

How can a squint be treated?

There may be several aspects of a squint problem that need to be treated to allow a successful visual and cosmetic outcome. An individual course of treatment is selected for each child. One or all of the following treatments may be needed;

Glasses: If a child needs glasses to correct the focusing problem of the eye they are most commonly prescribed for full time wear. Glasses can also be made with prism included in them to help some minor muscle imbalance problems.

Patching: The child may need some patching treatment where a patch is placed over the better eye to encourage the vision to improve in the squinting eye. Patching will not improve the alignment of the eyes or the cosmetic appearance of a squint.

Surgery: If glasses do not straighten the squint or the child doesn’t need glasses, surgery may be required to reposition the muscles which move the eye to achieve proper alignment.
Botox injections are sometimes given into the eye muscles to adjust the alignment.

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