About squints or strabismus in babies, children and teenagers
Children with squints have eyes that seem to look in different directions. This is because the muscles in each eye don’t work together in a balanced way.
Newborn babies can sometimes get squints that show up from time to time. This usually sorts itself out when they gain more muscle control, usually by about 6 months of age.
Squints can show up later in childhood too. They might come and go at first and then become more constant over time. Older children don’t grow out of squints.
Some squints in children are caused by long-sightedness. Rare causes of a squint can include a cataract in one eye or problems with the retina.
Squints can be quite common in premature babies or babies who have low birth weight. Eye problems like squints also tend to run in families.
A squint is also known as strabismus or ‘turned eye’.
Symptoms of a squint or strabismus
If your child has a squint, the eye with the squint might turn in towards the nose or outwards. Less commonly, the eye can turn upwards or downwards.
In general, squints become more obvious when children:
- are doing close activities like reading
- are tired or unwell
- have been outdoors.
The squint might also change depending on how much your child is concentrating.
A squint can lead to problems with vision, particularly in young children. For example, your child might see double or your child’s brain might ‘turn off’ one of their eyes to avoid double vision. If your child’s eye turns off constantly, it can lead to lazy eye.
Regular eye examinations: why they’re important
Regular eye examinations are the best way to detect conditions like squint and other vision problems.
It’s recommended that all children have eye tests:
- before they start preschool, when they’re 3-3½ years old
- in their first year of school.
Most states and territories run free vision screening programs through local child and family health services or schools. Check with your child and family health nurse or school about what’s offered in your area.
If a screening test picks up a problem with your child’s vision, the people running the screening program will let you know what to do next.
Does your child need to see a health professional about a squint?
Yes. If your child is over 3 months and you notice they have a squint or you’re worried about your child’s vision, start by seeing your GP or child and family health nurse. They might refer your child to an optometrist or ophthalmologist for more tests and checks.
Tests for squints
If your child is referred to an optometrist or ophthalmologist to test for a squint, this professional will carefully examine your child’s eyes and test their vision. This is to diagnose the problem and work out what’s causing it.
Squint diagnosis involves various tests and tools. For example, the optometrist or ophthalmologist:
- will check your child’s vision using an eye chart that has letters or symbols on it
- might use medication like eye drops to measure the focus of your child’s eyes
- might use equipment to work out whether glasses will help your child’s squint.
Treatment for a squint
Squint treatment aims to give good vision in both eyes, as well as straightening the eyes. Early treatment leads to better outcomes.
Squint treatment depends on the cause of the squint.
Your child might need to wear glasses, particularly if their squint is caused by long-sightedness.
Your child might need surgery to weaken or strengthen the eye muscles.
Sometimes an eye patch can help older children who’ve recently developed a squint and are having trouble with double vision.
Your eye specialist might also work closely with an orthoptist to manage your child’s squint.