Causes of a squint

A squint is usually caused by the muscles in each eye not working together in a balanced way.

Often squints are caused by long-sightedness. Rare causes can include a cataract in one eye or problems with the back of the eye (the retina).

Squints are 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, and you might hear people call it a ‘lazy eye’ or a ‘turned eye’.

Symptoms of a squint

Some squints are obvious in babies, and other squints show up later, after about two years of age.

If your child has a squint, his eyes will seem to look in different directions. The affected eye might turn up, down, in towards the nose or outwards.

Newborn babies sometimes look like this from time to time, but this usually sorts itself out when they gain more muscle control, after about three months. But if your baby’s eyes constantly look in different directions, you should take your baby to an eye specialist for assessment.

If your child still has a squint after three months of age, there’s also a chance she’ll develop a lazy eye (amblyopia). If your child has a lazy eye, her brain ignores the image coming from the affected eye. It’s a serious condition because it stops the eye from working properly and reduces vision.

In general, squints become more obvious when your child is tired or unwell. Squints can also change depending on how much your child is concentrating.

Squints affect about 5% of children.

When to see a doctor about a squint

A squint can reduce your child’s vision. Older children don’t grow out of a squint, and a squint won’t get better unless it’s treated.

Early treatment leads to better outcomes, so it’s really important that all children with a squint are seen by an eye specialist like an orthoptist or ophthalmologist.

You’ll need to see your GP to get a referral to an ophthalmologist, but you don’t need a referral for an orthoptist.

Treatment for a squint

The treatment of a squint depends on its cause.

Before treatment, the orthoptist and/or an ophthalmologist will thoroughly examine your child’s eyes. This will help the specialist work out what’s causing the squint and what treatment will help, including whether your child needs glasses.

All treatment aims to give good vision in each eye, as well as straightening the eyes.

A lazy eye can be corrected by placing a patch over the good eye, forcing the lazy eye to work by itself. This improves vision but doesn’t permanently straighten eyes.

If the problem is caused by the eye muscles not working together properly, your child might need surgery to shorten or lengthen one of the muscles. Your ophthalmologist will talk with you about the different ways to manage the squint and whether surgery is an option.

If you had a squint, lazy eye or turned eye as a child, or if one of your older children has one of these conditions, you should make sure younger children have an eye test at about three years of age, even if they don’t have a squint. Most states and territories run free vision screening programs. Check with your child and family health nurse or preschool to see what’s offered in your area.