It was one of those perfect autumn mornings—the kind where the sun’s warmth cuts through the brisk air, and golden leaves scatter across the playground like little pieces of sunshine. I had just wrapped up a hectic week at the clinic and decided to take a leisurely walk to clear my mind.
As I wandered closer to the swings, I spotted Mark, one of my neighbors, standing near the slide. His seven-year-old son, Ethan, was climbing up the jungle gym with a determined look on his face. But something caught my eye—the way Ethan’s right eye seemed to drift inward whenever he focused on the bars. Mark’s usual easygoing demeanor was replaced by a furrowed brow.
“Hey, Mark!” I called out, waving as I approached. He turned and smiled, though it didn’t quite hide the concern in his eyes.
“Morning, Priya,” he replied, giving a small nod. “Got a minute? I’ve been meaning to talk to you about something.”
I gestured to the bench nearby. “Of course. Let’s sit.”
We settled down, and Mark sighed deeply. “I’ve noticed something with Ethan’s eyes. Sometimes, his right eye doesn’t seem to align with the left one. It’s like it drifts inward, especially when he’s tired or concentrating hard. I’m worried it’s affecting his vision.”
I glanced at Ethan, now sitting cross-legged on the platform, happily chatting with his friend Zoe. “It sounds like Ethan might have a squint, or what we call strabismus,” I said gently. “But don’t worry—there are ways we can manage it.”
Mark’s shoulders relaxed slightly. “Can you tell me more about it?”
What Is a Squint (Strabismus)?
Image courtesy NHS
A squint, or strabismus, happens when the eyes are not aligned properly. One eye looks straight ahead, while the other may turn inwards (cross-eyes), outwards (walleye), upwards, or downwards. This misalignment is due to a lack of coordination between the six eye muscles that control eye movement and focusing.
When Does a Squint Become Obvious?
- Early Detection: Squints can be noticeable as early as the first few weeks of life.
- Typical Onset: Most squints appear between 2 weeks and 4 months of age.
- Later Development: Some squints don’t appear until children are 2 to 3 years old, or even later, up to 7 or 8 years.
Mark nodded, his eyes focused on Ethan. “So, it’s not something he was born with?”
“It might have been subtle at first,” I explained. “But as his vision develops, the squint becomes more noticeable.”
Types of Squints
I pulled out a notepad from my bag and sketched a quick table to help explain.
| Type of Squint | Description |
|---|---|
| Constant Squint | Always present; the eye is continually misaligned. |
| Latent Squint | Only appears when the child is tired or stressed. |
| Transient Squint | Briefly appears and then disappears. |
| Alternating Squint | The squint switches between the two eyes. |
| Pseudo Squint | Looks like a squint but is due to facial features, not eye misalignment. |
“From what you’ve described, it sounds like Ethan might have a constant squint,” I said.
What Are the Risks of a Squint?
Mark’s jaw tightened. “Is this going to affect his eyesight permanently?”
“There can be risks if it’s not treated,” I explained gently.
- Lazy Eye (Amblyopia): The brain starts ignoring signals from the weaker eye, causing vision loss in that eye.
- Double Vision: The brain struggles to merge two different images.
- Poor Depth Perception: Difficulty judging distances accurately.
“If a squint isn’t treated by the age of 6, there’s a danger that the ‘lazy eye’ might lead to permanent vision loss.”
How Is a Squint Diagnosed?
“It’s pretty straightforward to diagnose a squint,” I said. “We use the light reflex test or the cover test.”
- Light Reflex Test: A torch is shone into both eyes to see if the light reflects symmetrically.
- Cover Test: Each eye is covered alternately to see if the uncovered eye moves to focus.
“I’d recommend getting Ethan checked by an ophthalmologist as soon as possible.”
What Can Be Done?
Mark’s expression was a mix of relief and worry. “Is it treatable?”
“Yes,” I reassured him. “There are several ways to manage and treat a squint.”
- Glasses: Correct underlying vision problems.
- Patching: Covering the stronger eye to encourage the weaker eye to work harder.
- Eye Exercises: Strengthen eye muscles and coordination.
- Surgery: Adjust the eye muscles to correct alignment, typically for more severe cases.
“Treatment is most effective when started early. If surgery is needed, it’s best done before the age of 7.”
A Moment of Hope
We both watched Ethan and Zoe race toward the swings, their laughter echoing through the park. Mrs. Patel’s golden retriever, Bruno, bounded over to join them, his tail wagging wildly. Ethan bent down to pet him, his eyes lighting up with joy.
Mark smiled, a genuine smile this time. “He’s such a happy kid. I just want him to see the world as clearly as he can.”
I placed a reassuring hand on his shoulder. “We’ll make sure he does. You’re not alone in this.”
Mark’s eyes softened. “Thanks, Priya. That means a lot.”
FAQs About Squints in Children
1. Can a squint correct itself naturally?
In mild cases, yes. But most squints need treatment to correct.
2. How early should treatment start?
Ideally, before the age of 6 to prevent long-term vision issues.
3. Is squint surgery safe for children?
Yes, it’s a safe and effective procedure when performed by an experienced ophthalmologist.
4. Can wearing glasses fix a squint?
If the squint is due to a refractive error, glasses can help correct it.