Patient Care

Squinting of the Eye

Squint (strabismus) is the term used for the condition when the eyes are misaligned and not looking at the same thing. The common forms are when one eye either turns in or outwards. Vertical (up or down) misalignment is less common. Squint is a term also used when one squeezes the eyelid partly closed to see more clearly or against bright sunlight. When misalignment occurs each eye is directed at a different image and generally results in double vision (diplopia). However when squint occurs in childhood double vision generally does not occur.

Childhood squint often runs in families. Infants may be born with a squint. Usually the eye turns in (infantile esotropia) for the first week or two after birth. The eyes are often occasionally misaligned and this is normal and should stabilise within a month. Pseudo squint is a common condition in infancy and early childhood. The appearance of apparent squint is due to the structure of the tissue around the middle part of the face. This is known as the epicanthic fold and is on the inner aspect of each eyelid. It gives the impression that the eye is turning in as the white of the eye disappears underneath the epicanthal fold when the child looks either to one side or the other. Infants with true esotropia (convergent squint) usually squint with either eye. They often have an associated upward movement intermittently. Divergent squint is rare in infants and can mean there is a defect within the eye or neurological problem.

Convergent squint developing between the age of 18 months and four years is usually due to the child being very long sighted. The child will squint when looking at close objects as the child has had to focus hard to see clearly. Divergent squint (exotropia) often develops after four years and is usually intermittent occurring when the child is tired. The squint may become more obvious and occur more frequently as the child gets older. The child may experience double vision. Children with a congenital vertical squint may adopt a tilted head position to keep the eyes correctly aligned.