Squints or strabismus are common in children and sometimes occurs in adults. It means there is a misalignment of the eyes so they are not looking in the same direction. Most squints occur in young children and sometimes surgery is needed to correct the appearance of a squint.

What are the different kinds of squints?

Squints can be described using different terminology depending on the direction of the turning eye.Here are the different kinds:

• An esotropia is an eye that turns in towards the nose.
• On the other hand, an eye that turns outwards is called a exotropia.
• Hypertropia describes an eye that turns upwards.
• An eye that turns downwards is called hypotropia.

Certain squints may be present all the time, in which case they are labelled constant, while others come and go and are known as intermittent squints.When the affected eye turns out when the eyes are open, it is known as a manifest squint. When it only turns when the eye is shut it is known as a latent squint. This often looks fine when the eyes are open.

What is the difference between a concomitant squint and an incomitant squint?

A concomitant squint mans the angle of the squint never changes, so the eye muscles move well. This means the eye alignment will always be the same no matter which way you look. On the other hand, an incomitant eye means the angle varies. When you look to the left there may be no obvious squint. However, on the right they eye may not move as far, so there will be an obvious squint.

What causes squints?

There are a range of reasons why squints may develop.In some cases, children are born with a squint or develop it in the first six months of their lives for no apparent reason. This is known as a congenital squint.On the other hand, squints can also be related to refractive errors or vision problems such as myopia (short sightedness), hypermetropia (long sightedness) or astigmatism, when the eye ball is more oval-shaped rather than round. These conditions cause light to be focussed poorly on the retina. Children with refractive errors may find their eyes turn as they try to focus to see clearly. This mainly affects older children, over four years.

What is an amblyopia?

When a squint is not treated from a young age, it can develop into amblyopia, which is also known as 'lazy eye'. This occurs when the abnormal eye sends blurred images to the brain and the brain sometimes learns to ignore these messages. This needs to be corrected and can be treated with glasses if it is the result of a refractive error, or with an eye patch. This is placed over the normal eye to force the brain to recognise the images from the affected eye.

Can a squint come back in adulthood?

Some people may require glasses or contact lenses to correct a squint. If it returns in adulthood, sometimes eye exercises can be used to help improve its appearance. Sometimes, adding a prism to your glasses can also help as this diverts light in one eye, which can prevent if from turning out. This can make the glasses thicker, but is not always noticeable. If your squint becomes worse, surgery may be required. However, the best thing to do is to consult your optometrist for an opinion.