A squint occurs when one eye is straight and the other eye turns away from the straight position. This condition can happen at any age.

The squinting eye can turn inwards (convergent squint) or outwards (divergent squint). A squint can also be vertical, with one eye higher than the other.

Squints can be constant, present all the time. They can also be intermittent and occur under certain circumstances, like when the child is reading, is looking in the distance, or when he is tired. When a squint is constant, 3 things can happen :

When the child has a constant squint, he does not use the squinting eye to see and this will result in that eye having poor vision. An eye that has poor vision from lack of use is said to be lazy or amblyopic.

Poor Binocular Vision

The ability to appreciate depth or stereovision requires both eyes to be aligned so that they can be used as a pair. A child with a constant squint has no binocular or stereovision.

Abnormal Head Position

Some children adopt an abnormal head position like a tilt or face turn when they have a squint to try to keep both eyes aligned.

In a young child with a constant squint, surgery should be done once vision is equal in both eyes to enable binocular vision to develop.

In a child with intermittent squint, surgery is not so urgent as he can experience binocular vision some of the time.

In an adult, if the squint has been present for a long time and binocular vision is not possible, surgery can be done to improve his appearance.

Some squints can be caused by uncorrected long-sightedness (hyperopia) or short-sightedness (myopia).

Glasses can sometimes reduce or completely eliminate the squint and the need for surgery. Children with squints should have their eyes checked and glasses, if prescribed, should be worn at all times to help straighten the eyes.

If the glasses do not completely eliminate the squint, surgery is then needed for the remaining squint.

Many Asian babies, particularly among the Chinese, appear to have a convergent squint when folds of skin cover the inner part of the eyes. If a true squint is not present after medical examination, it is called a pseudo squint and treatment is not necessary.

A child with untreated amblyopia will always have defective vision. A child with a constant squint will have no binocular vision.

Early amblyopia treatment and/or squint operation may be required to enable the squinting child to have good vision in both eyes with normal binocular function.

Myth : "All babies squint."
Fact : They do not. Although the eyes are initially uncoordinated, control of eye
movements is achieved at approximately three months of age.

Myth : "Children under 2 cannot be examined."
Fact : No child is too young to be examined for a squint. If squinting is present and detected early, appropriate treatment can be given.

Myth : "No harm will occur if a squint is left alone as the child will outgrow it."
Fact : The child can suffer gross loss of vision (amblyopia) in the squinting eye.
This may become permanent if neglected. A squint may also rarely be due
to severe underlying diseases such as an eye tumour which requires
urgent treatment.

Myth : "You need not correct a squint that is not severe."
Fact : A small squint is as likely to result in amblyopia and defective binocular vision as a large squint. The child should be referred to the eye doctor as early as possible for treatment.

Myth : "Squints can be straightened at any age therefore delay does not matter."
Fact : Although surgery can be performed at any age, it may only improve the physical appearance. Early surgery (after appropriate amblyopia treatment) can restore full coordination of both eyes and lead to binocular vision.