A squint is clinically termed strabismus, an eye misalignment. Our brain is an amazing matrix that keeps our eyes straight. When this safeguard fails, a strabismus develops. This is one of the commonest eye conditions seen in children and can develop as young as four months of age. Of course, adults can develop this too, but the causes and visual implications are quite different.

An inward or outward turn are the commonest types of strabismus. A vertical or combined misalignment can also occur although less common. Our resilient brain may trigger a compensatory process, by adopting a new head positions or posture to help retain single vision.

What does this mean for vision?

Visual consequences do differ for children and adults. In children, if the turn favours one eye, a drop in vision can occur resulting in a lazy eye (amblyopia). It’s more a lazy brain than a lazy eye though. The critical period of vision development occurs up to age 7 so the sooner this is picked up and treated, the better. This is why school vision screening is crucial.

Children, fortunately, can ignore double vision as their amazing and rapidly developing brains have a compensatory mechanism called “suppression”. Adults however don’t tend to have such luck and will commonly see double and may adopt a head posture to adapt to this. This can make driving and day to day living quick tricky understandably.

What next doc?

Strabismus management again differs for children and adults. In children, the priority is to promote maximal visual development and realign the eye. This can be done with a combination of patching treatment, glasses and surgery. In adults, the goal is eliminating the troublesome double vision and realigning the eye with prisms or surgery.