Eye Health

23 April 2010

Squint (Strabismus) in a nutshell

Squint - a misalignment of the eyes - is usually the result of a problem with one or more of the muscles that move the eyes.

Squint - a misalignment of the eyes - is usually the result of a problem with one or more of the muscles that move the eyes. One of the eyes turns in or out, much less commonly up or down. Squint in children and squint in adults have different causes and are treated differently.

Squint in children
This affects about 2 – 3 out of every 100 children. Young children with squints suppress the image in one eye and do not have double vision. A squint in a small child will do permanent and severe damage to the vision in one eye – even blindness – if not treated promptly. This results in a “lazy” eye.

Squint in adults
The development of a squint in an adult causes double vision, but does not involve risks to the vision of the eye. However, the sudden onset of a squint in adulthood is often the result of serious nervous system problems and these require immediate medical attention.

When to see your doctor

  • Any baby or child with a squint should be seen by an ophthalmologist within a week of first noticing the problem.
  • An adult should see his family doctor immediately.


  • Patching: Many children require “patching”, forcing the child to use the lazy eye, even before prescription of glasses or surgery. Two hours a day may be enough. The specialist will prescribe the exact regimen.
  • Surgery: Squints in the first few months of life require surgery to reposition the muscles moving the eyeball. If not started early, squint treatment and surgery may realign the eyes, but not restore vision. Nevertheless, the cosmetic defect must be corrected for normal psychological development.
  • Glasses: Squints caused by far-sightedness are usually first noticed between 1 and 2 years of age. Initially one eye turns inwards intermittently, but as time passes the squint becomes constant. If treated early, prescription glasses can very effectively correct these squints.
  • Adults: All squints in adults require immediate medical attention.

Useful resources:

South African Optometric Association
Tel: 011 805 4517

South African National Council for the Blind
Tel: 012 452 3811

Retina South Africa
Tel: 011 622 4904

Ophthalmological Society of South Africa


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Megan Goodman qualified as an optometrist from the University of Johannesburg. She has recently completed a Masters degree in Clinical Epidemiology at Stellenbosch University. She has a keen interest in ocular pathology and evidence based medicine as well as contact lenses.

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