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Squints (Strabismus in Children)

Overview
Causes
Symptoms
Prevention
Treatment Options
Where to Seek Treatment
Singapore National Eye Centre
Contributed by Paediatric Ophthalmology & Adult Strabismus Service

SQUINTS (STRABISMUS)

More than just an aesthetic issue, ‘crossed eyes’ may affect vision development in children – but early detection and treatment can rectify the problem

What is a Squint?

Squint or strabismus is a condition where the two eyes are misaligned; ie. one eye looks straight and the other eye appears to look away. This condition can happen at any age. The squinting eye can turn inwards (convergent), outwards (divergent), or one eye can be higher than the other. Strabismus can result in decreased binocular or stereo (3D) vision, and children with strabismus can also develop a lazy eye (amblyopia).

What causes Squints?

Squints is most commonly cause by an imbalance of how the brain coordinates the eyes. It can also be caused by abnormal spectacle power (eg. high hyperopia or myopia), or anything that obscures the vision in one eye (eg. childhood cataracts or other eye abnormalities). Occasionally, it can also be the result of an abnormality of the nerves supplying the eye muscles or an abnormality in the eye muscles or surrounding tissues within the eye socket.

Early signs to look out for if your child has Squints

Parents will often notice that their child’s eyes may be poorly co-ordinated and not aligned. In some forms of strabismus, the children may close one eye to obscure the double image sometimes associated with strabismus, or tilt his/head to achieve better alignment.

Many Chinese babies often appear to have a convergent squint as a result of a prominent (Mongoloid) skin fold that covers the inner part of the eye, causing the eyes to appear closer together. This is a pseudo-squint, and no treatment is necessary. Your local doctor will often be able to tell you whether your child has a true strabismus or not, and will refer your child onto an eye specialist is he/she is uncertain or suspects a problem.

How do I help my child from developing Squints?

Unfortunately, squints cannot be prevented. It can, however, be controlled with medical intervention. 

What kinds of treatments are available for Squints?

Treatment varies with the type of squint present. In some, non-medical treatment (eg. spectacles and fusion exercises) are more appropriate, while in others, early surgery is necessary.

As squint may occasionally be associated with a more sinister brain or eye problem, the first thing your doctor will do is a thorough examination to ensure that no such problem(s) exists.

The principles of treatment are then to:

1. try to optimize vision in both eyes and provide children with appropriate spectacles,
2. treat any underlying amblyopia (lazy eye),
3. nonsurgical treatment such as eye patching, fusion or convergence exercise where applicable to
    teach children how to use both eyes together, and
4. perform surgery to realign the eyes, if necessary.

Please visit the following relevant links :-

Paediatric Ophthalmology & Adult Strabismus Service
Paediatric Ophthalmology & Adult Strabismus Clinical Staff
I Want an Eye Examination / an Appointment
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Read more on other Eye Condition and Treatment

Lazy Eye (Amblyopia)


Where to Seek Treatment

The medical institutions within SingHealth that offer consultation and treatment for this condition include:

1. Singapore National Eye Centre
Paediatric Ophthalmology & Adult Strabismus Service
11 Third Hospital Avenue, Singapore 168751

Appointments Hotline:
Tel : +65 6227 7266

International Enquiries, please contact:
Tel : +65 6100 9393
Email : ips@snec.com.sg
2. KK Women's and Children's Hospital
Children's - KK Eye Centre
100 Bukit Timah Road Singapore 229899

Appointments Hotline:
Tel : +65 6294 4050

International Enquiries, please contact:
Tel : +65 6394 8888
Email : international@kkh.com.sg


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