Childhood squint 

A paediatric consultant explains the causes of squints, a misalignment of the eye. He describes how to identify the symptoms and the treatment options.

Learn about treatment for a squint

Transcript of Childhood squint

My name is John Sloper.

I'm a consultant working at Moorfields Eye Hospital

and specialising in the treatment of squints and children with lazy eyes.

A squint occurs when the two eyes don't point in the same direction.

This means that the two eyes see different things

and the brain can't combine the images from the two eyes.

As a result of this the brain ignores one eye

and the vision in that eye can deteriorate,

and this is termed amblyopia.

Amblyopia is a very common problem, affecting about one child in 20.

Squints can come on in children at any age,

but commonly either in very small babies between four and six months

or else at the age of two or three,

and it's important up to about the age of seven,

because that's the age at which it can affect the development of vision.

The main thing that parents notice

is that the two eyes are not pointing in the same direction.

They can see this when they look at the child.

Sometimes the eyes are like this all the time, sometimes just some of the time.

A lazy eye is more difficult to diagnose

because it can also occur because the focus in the two eyes is different,

and so the vision in one eye deteriorates.

Not uncommonly this is not detected and can be a problem.

When we first see a child with a squint,

the immediate question is whether the vision is good in both eyes.

The first line of treatment for poor vision is usually glasses,

and once the child is used to glasses then we may need to patch the good eye

to improve the vision in the poor eye.

This will result in good vision in both eyes

in about 80 per cent of children who we see.

When we treat a child with a squint, we're aiming to achieve three things.

The first is to get good vision in both eyes,

and that is usually achieved by patching and can usually be done.

The second is to try and make the eyes work together.

This we achieve in a minority of children,

but can be very useful when we do it.

The third thing we can usually achieve is to make the eyes look straight.

This is very important for the child in interacting with their friends.

Squint surgery is a little bit uncomfortable,

but the eyes usually settle down pretty quickly

and children bounce back very quickly from squint surgery.

When we achieve good vision in each eye, this is usually permanent,

and if the eyes work together this is normally long-lasting.

If the eyes don't work together,

then over a number of years, often 20 or 30 years,

the affected eye may drift out again

and this can be corrected with further squint surgery as an adult.

Most children are much happier after squint surgery

and parents often comment

that things like their balance and coordination are better.

Complications of squint surgery are fortunately extremely rare.

Most squint surgery is done as a day case.

The child comes into hospital first thing in the morning,

has surgery during the morning

and is able to go home usually during the course of the afternoon.

If you're concerned that your child has a squint,

the first thing to do is to consult your general practitioner.

They can then refer you

to an appropriate eye department in an eye hospital.

Squints are a common problem and a lot can be done to improve squints,

however it is important that we see children with squints early

and the earlier we see them, the better the results, in general, of treatment.

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