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The Diva Eye institute has behind it a robust history of eighty years of eye care in the state of Gujarat.


Strabismus, commonly called squint, is a misalignment of the eyes so that they are pointed in different directions. It is a common condition, affecting 4% of children, but may appear later in life. The squint may be permanently obvious, or may be noticed on and off. It may be present in one eye only or may alternate between the two eyes. The misaligned eye may turn upwards, downwards, inwards or outwards. Strabismus is also sometimes called "lazy eye".
  • Squint is caused by imbalance of the eye muscles. There are six eye muscles attached to the outside of each eye, which control its movements in all directions. In order to focus both eyes on an object all the eye muscles of each eye must be balanced and working together with the corresponding muscles of the opposite eye. When these muscles do not work together the eyes become misaligned i.e. strabismus occurs. When one eye turns, that eye is not focused properly which can lead to a deterioration of vision in the squinting eye.
  • Refractive (focusing) errors may also contribute.
  • Squint may run in families.
  • It occurs equally amongst both sexes.
  • As the brain controls the eye muscles, children with problems such as cerebral palsy or Down's syndrome often have a squint.
  • If an injury or cataract causes blurring of vision in one eye, it may become misaligned.
When one looks at an object, its image is focused on the retina and then relayed to the brain. If both eyes are well aligned, they will focus on the same object and the brain will fuse the two images into a single, three-dimensional picture. This allows perception of depth and "binocular vision".

When one eye is misaligned, as in squint, two separate pictures are seen by the brain. In the younger child, the brain trains itself to ignore the image from the turned eye and sees only the one from the straight eye. Hence there will be no depth perception or binocular vision. When strabismus develops in adults, the brain is already trained to receive both images and hence double vision results.

If the eyes are both well aligned, good vision develops in both. Mal-alignment may cause reduced vision in that eye - Amblyopia - as the brain will ignore the image of the weaker eye. In this way about half the children with strabismus develop amblyopia. This can be reversed by patching the strong eye in order to strengthen the vision in the weaker one. Patching is successful if amblyopia is detected in the first few years of life. Later on amblyopia or reduced vision may become permanent.

  • The main symptom is that the eye is not straight.
  • Squinting in bright sunlight
  • Faulty depth perception
  • Tilting of head in a particular direction so as to use the two eyes together
  • Fatigue or illness may worsen strabismus

A child cannot outgrow a squint - it has to be treated by a specialist
Sometimes squint cannot be detected by parents, even on close observation. Hence all children, especially those with a family history of the disorder, should be examined during infancy and pre-school years.The earlier the diagnosis, the better will be the results of treatment. If one delays eye examination till school-going age, it may be too late to achieve proper correction of the squint and visual deterioration in that eye.

Some babies may appear to have a squint that is not a true squint. It is called 'epicanthus' and is caused by folds of skin on a wide nose. Your doctor will easily be able to distinguish epicanthus from true strabismus.

Rarely, a squint can be caused by a cataract or a tumour in the eye. The earlier this diagnosis is made the better the management of both the condition and the resulting squint.

Other children should also be examined as it tends to run in families.
  • Your child will NOT grow out of the squint
  • Sight will get worse in the affected eye
  • He may be teased about his appearance / He may be precluded from some jobs later
  • If at some later point the sight in the better eye is lost e.g. by accident, the squinting eye will not be able to compensate and your child would be visually handicapped.
  • To preserve vision
  • To straighten the eyes
  • To restore binocular vision
Once squint is diagnosed, one or more of the following will be necessary for proper treatment:
  • Covering or patching of the good eye will force use of the amblyopic eye. This is necessary to ensure equal vision
  • Surgery on the eye muscles to align the eyes. The earlier the surgery is performed, the better the chances are of developing normal sight and binocular vision. Later on it may not be possible to achieve normal sight and binocularity, although cosmetic straightening of the eyes can be achieved. Correction of the cosmetic defect will also improve self-image and confidence.
  • Eye glasses, special lenses called prisms may be required in certain cases. Rarely eye exercises (orthoptics) may help older children to control the misalignment. However exercises alone cannot cure squint.