Squint is a condition where the eyes are not straight all the time and the muscles moving the eyes are not balanced correctly. Usually one eye appears straight while the other is turned in (convergent squint) or out (divergent squint).

What causes a squint?
There are several types of squint, and the cause is not always known. Usually however, it is either apparent soon after birth- a congenital squint- or may develop later and be associated with long sightedness (hypermetropia). Whatever the cause, a squint may lead to a lazy eye (Amblyopia).

What is Amblyopia?
Visual development occurs during the first seven years of life. If the eye and the brain do not receive a clear focused image the development will be impaired and the vision will be reduced- a so called lazy eye or amblyopia results. So amblyopia is caused by:-

A squint
A large difference in the spectacle correction required by each eye
The need for strong glasses

Does a squint matter?
Some minor squints do not cause any problems but many squints will result in a lazy eye or amblyopia if left untreated. Also, a large squint may not be attractive cosmetically.

How is a child tested for a squint?
The optometrist, orthoptist or ophthalmologist will test:-

The child’s vision

The straightness and movements of the eye

The need for glasses.

Why are drops required to test for glasses?
The drops prevent the child from focusing during the test and allow more exacting examination of the inside of the eye. This is usual, standard practice in the examination of children and it is nothing to worry about. The drops take up to 40 minutes to work and last up to 24hours.

What treatments are available for squints?
There are 3 main forms or treatment and any or all of them may be necessary at some stage.

Glasses
Spectacles are prescribed in order to produce a clear image on the retina at the back of the eye or to help in the control to keep the eyes straight.

Patching
If there is any amblyopia, the good eye is patched in order to encourage the weaker or a lazy eye to be used.

Surgery
If a squint persists despite these treatments an operation to reposition the relevant muscles attached to the eye may be necessary. For this operation a general anaesthetic is necessary but the child may be able to go home the same day or at the latest the next day. A course of eyedrops will be prescribed and close follow up will be required initially. It is probable that if glasses were required before the operation, they will be need to be worn post operatively, at least to begin with.

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