What is a squint?
A squint, also known as strabismus, is a condition where the eyes are not looking in the same direction. While one eye looks straight ahead, the squinting eye may turn inwards (convergent squint) or outwards (divergent squint). A squint can also be vertical with one eye higher than the other. This condition can happen at any age. Squints can be present all the time or be intermittent, occurring in certain situations, like when the child is reading, tired or looking in the distance.
A squint can result in defective binocular or stereovision (3D vision). Children with squints can also develop lazy eye (medically termed “amblyopia”).
What are the causes of squint in children?
A squint is commonly caused by an imbalance in the way the brain controls the eyes. It can also be caused by abnormally high spectacle power (e.g. hyperopia or long-sightedness), or anything that obscures the vision in one eye (e.g. childhood cataracts). Occasionally, it may be due to an abnormality of the nerves supporting the eye muscles, or an abnormality in the eye muscles or surrounding tissue within the eye socket.
What are the early signs to look out for?
Parents will often notice that their child’s eyes may be poorly coordinated or not aligned. In certain types of squints, the child may close one eye to obscure a double image, or tilt his/her head to achieve better alignment.
Many Asian children often appear to have a convergent squint as a result of a prominent skin fold that covers the inner part of the eye, causing the eyes to appear to turn inwards (towards the nasal bridge). This is a pseudo squint, and no treatment is necessary. Your child’s paediatrician or doctor will often be able to tell you whether your child has a true or pseudo squint, and will refer him/her to an ophthalmologist for further assessment and treatment.
What are the treatments for squints?
Treatment varies with the type of squint present. In some, non-medical treatment (e.g. spectacles, eye patching, eye exercises, etc.) are more appropriate; while in others, eye muscle surgery is necessary.
As squints may occasionally be associated with an underlying brain or eye problem, the ophthalmologist would perform a thorough eye examination to exclud such problems.
