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Squints

Squints: Overview, treatment and myths | KKH

Squints - What it is

​Squints In Children

A squint occurs when the two eyes are not looking in the same direction. Squints can happen at any age. The medical term is "strabismus".

The squinting eye can turn inwards (convergent squint) or outwards (divergent squint). A squint can also be vertical, with one eye higher than the other.

Squints in children - KKH

Squints can be constant (i.e. present all the time) or they can be intermittent and occur under certain circumstances, e.g. reading, looking in the distance, or when tired. When a squint is constant, the following can occur:

  • Amblyopia or Lazy Eye: When the child has a constant squint, the squinting eye is not used to see and this can result in that eye developing poor vision. An eye that has poor vision from lack of use in childhood is said to be lazy or amblyopic. Squints can cause amblyopia and amblyopia can cause squints.
  • Abnormal Head Position: Some people adopt an abnormal head position like a tilt or face turn to try to keep both eyes aligned when they have a squint.
  • Defective Stereovision

Squints - Symptoms

Squints - How to prevent?

Squints - Causes and Risk Factors

Squints - Diagnosis

Squints - Treatments

​Treatment for a child with a squint consists of two parts.

1 Maximising vision

  • People with squints should have their eyes checked and glasses, if prescribed, should be worn at all times to help straighten the eyes.
  • In children, existing amblyopia must be treated first. This is done by patching the good eye so that the child is forced to use the lazy eye. When the vision in the amblyopic eye becomes normal, the child will use each eye equally and the squint will be noted to alternate between the eyes.

2 Surgery

  • Once vision is restored but the squint persists, squint surgery is performed to realign the eyes and to allow binocular vision to develop. Binocular vision only develops in early childhood to give 3-dimensional vision or stereo vision.

When Should Surgery Be Done

  • In a young child with a constant squint, surgery should be done once vision is equal in both eyes to enable binocular (3-dimensional) vision to develop.
  • In a child with intermittent squint, surgery is not so urgent as he can experience binocular vision some of the time.
  • If a constant squint develops later than 2 to 3 years of age, i.e. the age after binocular vision has been established, straightening the eyes by surgery can help regain stereo (3-dimensional) vision. However, if a constant squint appears in the first year of life, i.e. before binocular vision develops, the eyes often do not have very good stereo (3-dimensional) vision even after squint surgery.

Accommodative squint (convergent)

Longsighted glasses can reduce or completely control this type of squint. Sometimes bifocals are prescribed if the squint angle is worse for near than for far vision. But if the glasses do not completely eliminate the squint, surgery is then needed for the remaining squint.

Pseudo Squint

Many Asian babies, particularly among the oriental races, appear to have a convergent squint when a flat nose bridge covers the inner part of the eyes. If a true squint is not present after medical examination, it is called a pseudo (false) squint and treatment is not necessary.

Importance Of Early Treatment

Amblyopia if not treated in childhood will cause permanent poor vision. A child with a constant squint will not have 3-dimensional vision.

Early amblyopia treatment and/or squint operation may be required to enable the squinting child to have good vision in both eyes and normal binocular function.

Squints - Preparing for surgery

Squints - Post-surgery care

Squints - Other Information

​Some Myths About Squints

Myth: "All babies squint."

Fact: They do not. Although the eyes are initially un-coordinated, control of eye movements is achieved at approximately three months of age.

Myth: "Children under two cannot be examined."

Fact: No child is too young to be examined for a squint. If squinting is present and detected early, appropriate treatment can be given.

Myth: "No harm will occur if a squint is left alone as the child will outgrow it."

Fact: The child can suffer loss of vision (amblyopia) in the squinting eye. This may become permanent if neglected.

Myth: "You need not correct a squint that is not severe."

Fact: A small squint is as likely to result in amblyopia and defective binocular vision as a large squint. The child should be referred to the eye doctor as early as possible for treatment.

Myth: "Squints can be straightened at any age therefore delay does not matter."

Fact: Although surgery can be performed at any age, it may only improve the cosmetic appearance. Early surgery (after appropriate amblyopia treatment) provides the chance for full coordination of both eyes and binocular (3-dimensional) vision.

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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