Why Does My Child Have A Squint And What Should I Do?

One of your children’s eyes may turn inwards, upwards or outwards when they are trying to focus on an object. In some cases, this may be only visible in photographs and this is often where parents will notice it for the first time. My own son started to show signs of a squint at just a couple of months old and while I never noticed it in person I noticed it in a lot of photographs. 

One in twenty children are affected by this issue and it tends to develop before your child is at preschool age. Some squints can be congenital (the child is born with it) and others can develop when they are a baby. It is usually a muscular issue that results in the eye muscles not working together in harmony. There are many eye muscles and they have to work in a balanced way for the eyes to move and work together correctly. 

In some cases, a squint may be intermittent. Many parents notice it when their child is tired for example. It can also be something that only happens when your child is distracted or daydreaming. In other cases, it is a constant thing. If you are concerned it is important to speak to your public health nurse or GP so that the necessary steps can be taken to investigate the squint. If your baby is very small there is a strong possibility that the PHN will simply make a note of it and observe it for a number of months. This is because a lot of children simply grow out of it and a lot of babies cross their eyes naturally without their being an underlying issue. 

If a squint is left unattended there can be some serious implications. In the case of a lazy eye, the vision in one eye becomes very poor due to the fact that the eye has not been used enough. This type of vision loss is beyond correction with glasses and can be permanent if it is left untreated for too long. 

A squint can lead to one eye working a lot harder than the other. The eye that turns (in, out or upwards) is not used to focus and therefore fails to develop properly because the brain does not process the signals from that eye in the same way as the dominant eye that is doing most of the work. 

A squint does not always lead to sight issues. It can be a completely cosmetic issue as is the case for my son. Right now he has quite an obvious turn in one of his eyes and yet his vision in both eyes is much the same. In cases where it is cosmetic, the problem can be self-esteem for your child. In some cases, surgery might be offered to correct the squint when they are about seven years old. 

It is really important that a squint is detected as early as possible to ensure that it is being reviewed regularly. You will be referred to an orthoptist who may then refer you to an ophthalmologist. Waiting lists on the public system can be very long and we were personally waiting over two years for an appointment. In the meantime, we paid privately for one consultation for peace of mind. The sooner you raise the issue with your PHN or GP the sooner your appointment will come around. 

Your child will undergo many different tests which will be age and stage appropriate. In some cases, they will be given eye drops which help dilate the eyes and make it easier to examine them. The team may suggest doing nothing at all other than regular reviews at their clinic.

Alternatively, they may suggest patching or glasses. Patching is the practice of restricting the use of the “good” eye so that the eye with the turn/squint is forced to work harder and built strength. You will be advised on how often the patches should be used. In our case, it was three hours per day. In many cases, patching can really improve sight loss associated with the squint but it does not necessarily fix squint itself.

In other cases, glasses may be a solution as the squint may also go hand in hand with being short or long-sighted. 

If surgery is offered the team will be hopeful that it will straighten the eyes and correct the squint. It has a high success rate but there are also many cases which result in the squint returning some years later thus requiring further surgery.