Squint (Strabismus): Symptoms, Causes & Treatment

Overview

Normally, both eyes work together and point in the same direction, allowing the brain to combine the images into a single, three-dimensional view. In squint, the eyes are misaligned — one eye may turn inward, outward, upward or downward relative to the other, either constantly or intermittently.

Squint is most commonly noticed in childhood, but it can also develop in adults due to nerve, muscle or other underlying problems. In children, if squint is left untreated, the brain may start to ignore or suppress the image from the misaligned eye, leading to amblyopia (lazy eye) with permanently reduced vision — this makes early diagnosis especially important.

Symptoms

• Visibly misaligned or crossed eyes, constant or intermittent
• Closing or squinting one eye in bright light
• Tilting or turning the head to see better
• Double vision (more common in adult-onset squint)
• Reduced depth perception
• Poor vision development in the affected eye if untreated in childhood

Causes

• Uncorrected refractive error, particularly high hypermetropia, in children
• Imbalance in the eye muscles controlling eye movement
• Nerve problems affecting eye muscle control
• Underlying conditions such as diabetes, thyroid eye disease, or after a stroke in adults
• Family history of squint
• Certain childhood conditions present from birth

Risk Factors

• Family history of squint or amblyopia
• Significant uncorrected refractive error in children
• Premature birth or low birth weight
• Diabetes, thyroid disease, or neurological conditions in adults
• Previous eye or head injury

When to See a Doctor

Any noticeable misalignment of a child's eyes, at any age, should be evaluated promptly — earlier treatment gives the best chance of normal vision development in both eyes.

Adults who suddenly develop double vision or a new squint should seek prompt evaluation, as this can occasionally point to an underlying nerve or systemic condition needing attention.

Diagnosis

Squint is diagnosed through a detailed assessment of eye alignment, eye movements, and vision in each eye separately, along with a full refraction to identify any underlying focusing error.

Tests

• Visual acuity testing in each eye separately
• Detailed assessment of ocular alignment and eye movements
• Refraction under dilation, particularly important in children
• Slit lamp and dilated retina examination to rule out other underlying causes

Treatment Options

Treatment depends on the type, cause and age at diagnosis, and is often combined for the best result.

• Spectacle correction when refractive error is contributing to or causing the squint
• Patching therapy of the stronger eye in children to encourage vision development in the weaker eye (amblyopia treatment)
• Eye exercises for certain types of squint, particularly convergence-related problems
• Squint surgery to realign the eye muscles when non-surgical measures are not sufficient
• Treatment of any underlying systemic cause in adult-onset squint

Expected Outcomes

Outcomes are best when childhood squint and amblyopia are treated early, ideally before the age of 6–7 years, while the visual system is still developing. In adults, treatment can improve alignment, comfort and double vision, though the degree of improvement depends on the underlying cause.

Why Choose Dr. Murkute's O2 Bone & Eye Care

• Careful assessment of eye alignment and vision in children and adults by Dr. Dipti Murkute (Pansare), MBBS, DNB Ophthalmology, FICO (UK)
• Age-appropriate, patient explanation of treatment options for anxious young patients and parents
• Structured follow-up to monitor patching therapy and treatment response
• Coordinated evaluation for adult-onset squint linked to systemic conditions
• Convenient Kharadi location for patients across East Pune