Squint in children
Date issued: September 2015
For review: September 2017
Ref: A-280/AM/REI/Squint in children
PDF: Squint in children [pdf] 117KB
What is a squint?
A squint is when the eyes wander either in towards the nose (convergent squint or esotropia) or outwards (divergent squint or exotropia). Occasionally the eye can drift up or down.
The squint may be seen only when the child is tired or concentrating, or may be there all the time. 1 in 20 children up to the age of 5 will have a squint.
What causes a squint?
Squints can have several causes
1. Long sightedness, the child has to focus to see clearly and this causes the eye to turn in.
2. An imbalance between the muscles that control eye movement.
3. Infantile or congenital squint, some babies are born with one eye turning in.
4. Rarely there is a problem with the eye itself.
Can the squint affect the vision?
If one eye is constantly turning in, the vision in that eye may not develop normally, this is called amblyopia
If the eyes are not working together this can affect 3D vision. This is unlikely to cause a lot of problems in the child’s everyday life but may affect some career choices e.g. pilot, lorry driver.
What happens at the clinic?
All children will be seen by an Orthoptist who will measure the vision and eye movements.
All children will need a refraction (test for glasses) which will usually need eye drops. The drops dilate the pupils and relax the focusing to enable an accurate test and examination of the back of the eye.
What is the treatment?
Glasses.
If the child is long sighted they will be given glasses. This will help with focusing and therefore will help to straighten the eyes. The squint will still be noticeable without the glasses.
Glasses are sometimes needed to treat reduced vision in one or both eyes.
Amblyopia treatment.
If the vision is reduced in one eye it is important to treat this with patching or drops. The patch is worn on the good eye for 1-6 hours a day to make the child use the other eye. This will not change the appearance of the squint.
Sometimes drops are used instead of a patch.
Operation.
If the child doesn’t need glasses or the glasses don’t fully correct the squint then an operation may be needed. The operation is aimed at improving the appearance of the eyes and doesn’t improve the vision. Amblyopia treatment is carried out before surgery.
People in the eye clinic.
An Orthoptist will assess vision, diagnose and measure squints and treat amblyopia.
An Optomotrist(optician) will test for glasses.
An Ophthalmologist (eye doctor) will examine the eyes, test for glasses and discuss diagnosis and treatment.
If you have any questions contact
Orthoptic Depatment
REI
Derriford Hospital, Plymouth PL6 8DH.
01752 439319
