The London Squint Clinic
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About Squints

Q: What is a squint?
A: A squint is a misalignment of the two eyes. In a squint, one or both of the eyes are not pointing in the correct direction. (Doctors don’t tend to use the word squint in the way that many people do, to mean screwing up the eyes to try and focus on something.)
 
Q: What does the word “strabismus” mean?
A: Strabismus is the medical term for squint. A strabismus surgeon is a specialist squint surgeon. 

Q: Are there different types of squint?
A: There are many different types of squint. Children's squints are quite common. They have different causes, different effects and different treatments. One of the ways we divide the different types of squints is the direction in which the eyes turn of drift. An eye that drifts toward towards the nose is call a convergent squint (ESOtropia). An eye that drifts off to the side is called a divergent squnt (EXOtropia). In addition, there are vertical squints and more complex squints.

Q: What causes squints?
A: The general answer is that the muscles which move the eye are out of balance. This in turn can be due to a variety of issues. The commonest one for children is simply that the brain control of the eye muscles didn't develop normally. This isn't a specific disease in the brain - it's just they way things formed. This causes an imbalance in the control messages being sent from the brain to the eye muscles. It is like a car that is veering out of its lane on the motorway: it could be due to a burst tyre but it is often due to the driver not concentrating on keeping straight.

Q: How many muscles move the eye?
A: There are six muscles that move each eye. These are supplied by three nerves that come from the brain. A problem with any of these muscles or nerves gives a different pattern of squint.

Q: Isn’t squint the same as lazy eye?

A: No, although you may hear people using the term lazy eye when they mean squint. Eye doctors do use the term “lazy eye”, but they use it to means amblyopia, not squint.

Q: What is amblyopia?
A:  Amblyopia is reduced vision in one of the eyes due to a problem with vision during childhood. If you don’t have two aligned eyes with clear, focused images sending equal signals to the brain during childhood, then some of the normal wiring connections in the brain don’t develop properly. This leaves one eye weaker than the other. You can think of it like the brain ignoring the eye with the problem. Normally, if you developed amblyopia in childhood, it stays with you for life.

Q: Do glasses help squint?
A: Some squints are helped by wearing glasses, especially certain childhood squints where the eyes are turned in. For some of these squints, the glasses may be all that is required. For many other types of squint, however, glasses may have no effect. We will advise you whether your or your child’s squint is the type that glasses can help.

Q: Do squints matter?
A: If a person’s quality of life is affected by their squint then definitely the squint matters! If a person has a squint, but is not aware of it and is not troubled by it then often it doesn’t matter. The major exception to this is if the squint is a sign of a serious disease process – in that case it matters a lot, even if the person is not aware of it. After examination and sometimes investigation, we can reassure you that your squint is not due to a serious cause.

Q: What problems can squints cause?
A: Young children themselves are often not aware that they have a squint or lazy eye. However, at younger ages, treatment of lazy eye is very important to give children the best chance for good vision in later life. As children get older, squints can cause problems with social interacting and occasionally teasing. In teenagers, self-image, self-esteem and self-confidence become important issues which can be affected by a squint.

Q: Do other people notice my child's squint?
A: Many parents ask this question. Sometimes people assume that other people must be noticing their child's squint but are too polite to say. Actually, small squints can be hard to notice. Only when the angle gets larger do squints become noticeable. This is one of the things that we can advise you about.

Q: Can squint and lazy eye be treated?
A: In the majority of cases the answer is YES! Please see the Squint Treatment section.

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