What is a Squint?
A squint is when both eyes do not look in the same direction at the same time. One eye may turn inward, outward, upward, or downward while the other eye looks straight ahead. It is a common condition, especially in young children, but it can affect adults too. With the right squint treatment, most people see a significant improvement.
Understanding Squint
Squint is one of the most common eye conditions seen in children in India. Studies suggest it affects roughly 1 in 20 children, and it is also seen in adults who develop it after illness, injury, or due to other health conditions.
The eyes are controlled by six muscles each, and all twelve muscles need to work in perfect coordination. When the muscles of one eye are stronger or weaker than those of the other, or when the brain is not sending the right signals, one eye starts to drift out of alignment. This is what causes a squint.
Many parents notice a squint when their child is a few months old, or when the child starts school. Some children are born with it, while others develop it between the ages of one and four. In adults, a squint that appears suddenly should always be checked by a doctor promptly, as it can sometimes indicate an underlying health condition.
What are the Symptoms of Squint?
The symptoms of squint are usually noticed by parents, teachers, or the person themselves. The symptoms of squint can range from a constant, obvious turn of the eye to one that only appears occasionally when a person is tired or concentrating.
Signs to Watch For
Sign | What it looks like |
Eyes not aligned | One eye turns in, out, up, or down while the other looks straight ahead |
Comes and goes | The misalignment may only appear when the child is tired, unwell, or concentrating hard |
Blurred or double vision | Some people, especially adults, see two images of the same object |
Squinting or closing one eye | The child may shut one eye in bright sunlight or to try and see better |
Tilting the head | Turning the head to one side to compensate for the misalignment |
Trouble with reading or focus | Difficulty concentrating on close-up tasks like reading or drawing |
Self-consciousness | Older children and adults may feel embarrassed about how their eyes look |
What are the Types of Squint?
Understanding the types of squint helps the doctor plan the right squint treatment. The different types of squint are usually described by the direction the eye turns and by when the condition appears. Some types of squint are constant, while others come and go.
The Main Types of Squint
- Esotropia (Inward Squint) In this type, one eye turns toward the nose while the other looks straight ahead. It is one of the most common types of squint in children and is often linked to longsightedness. In many cases, correcting the spectacle number with glasses can significantly improve the alignment.
- Exotropia (Outward Squint) In this type, one eye turns away from the nose, drifting outward. It is seen in both children and adults. It may be constant or intermittent, often appearing when the person is tired, daydreaming, or looking into the distance.
- Hypertropia (Upward Squint) In this less common type, one eye turns upward compared to the other. It can be related to nerve or muscle issues affecting the control of vertical eye movement, and it often causes a head tilt to compensate.
- Hypotropia (Downward Squint) In this type, one eye turns downward. It is often associated with injury, muscle weakness, or nerve palsy affecting the muscles that control upward eye movement.
Types of Squint at a Glance
Type | What happens | Common in |
Esotropia (inward squint) | One eye turns toward the nose | Children, often linked to longsightedness |
Exotropia (outward squint) | One eye turns away from the nose | Both children and adults |
Hypertropia (upward squint) | One eye turns upward | Less common, can be related to nerve issues |
Hypotropia (downward squint) | One eye turns downward | Often associated with injury or muscle weakness |
What Causes a Squint?
The squint causes are different depending on the age of the person and the type of squint involved. In many children, the squint causes are linked to how the eyes and brain are developing. In adults, the squint causes are more often related to health conditions that affect the muscles, nerves, or brain. Knowing the squint causes helps the doctor choose the right squint treatment approach.
In Children
Uncorrected spectacle numbers: This is one of the most common squint causes in Indian children. When a child has a high longsighted number and it has not been corrected with glasses, the eyes have to work very hard to focus, especially on near objects. Over time, this extra strain can cause one eye to turn inward. Correcting the spectacle number early can prevent or even reduce the squint.
Family history: Squint does run in families. If a parent or sibling has had a squint, the child has a higher chance of developing one. This does not mean it will definitely happen, but it is worth getting the child’s eyes checked early.
Problems with eye development: Sometimes the eye muscles or the nerves that control them do not develop as they should before birth, which can result in a squint from infancy.
Other childhood conditions: Certain conditions like Down’s syndrome, cerebral palsy, and a history of premature birth increase the likelihood of a squint. Rarely, a squint in a child can be a sign of retinoblastoma (a childhood eye cancer), so it is important to always get a squint evaluated by a doctor.
In Adults
Health conditions affecting the brain or nerves: A stroke, a head injury, or conditions like multiple sclerosis can affect the nerves that control the eye muscles, causing an adult squint.
Diabetes: High blood sugar over a long period can damage the small blood vessels that supply the nerves controlling eye movement. This can lead to a sudden squint in adults.
Thyroid eye disease: An overactive or underactive thyroid can cause the muscles behind the eye to swell and stiffen, pulling the eye out of its normal position.
After eye surgery or injury: Sometimes a squint can develop or worsen after an eye procedure or physical injury to the eye area.
What Does Squint Treatment Look Like?
Squint treatment is planned around the type of squint, its cause, the age of the person, and whether a lazy eye has developed alongside it. In many cases, squint treatment is a step-by-step process rather than a single intervention.
The most important principle in squint treatment is that the earlier it begins, the better. The first seven to eight years of life are the critical period for visual development. Squint treatment started within this window has a much higher chance of preserving good vision and achieving proper alignment.
Squint Treatment Options
- Glasses: Starting point for many If the squint is caused by a spectacle number that has not been corrected, simply getting the right glasses can make a significant difference. This is especially true for children with an accommodative squint linked to longsightedness. In many cases, wearing glasses regularly reduces or corrects the squint without any further squint treatment needed.
- Patching (Lazy Eye Treatment): For children with a lazy eye If a lazy eye has developed alongside the squint, patching squint treatment is used first. A patch is placed over the stronger eye for a few hours each day, forcing the brain to use the weaker eye and build up its vision. This does not straighten the eye, but it ensures that the vision in the affected eye is strong enough before further squint treatment is done.
- Eye Exercises: Non-surgical support In certain types of squint, particularly in adults or older children, eye exercises can help train the eyes to work together. These are usually done under the guidance of an orthoptist (a vision specialist who works alongside the eye doctor). Eye exercises are not a standalone squint treatment for all types, but they support recovery and improve coordination after other treatments.
- Botox Injections: For selected cases A small injection of Botulinum toxin (Botox) into one of the eye muscles can temporarily weaken it, allowing the eyes to realign. This squint eye treatment is used in specific situations, particularly when surgery is not immediately suitable or when the doctor wants to assess how the eye responds before planning surgery. The effect typically lasts a few months.
- Squint Surgery: For moderate to severe cases Surgery is a common and well-established squint eye treatment for cases that do not respond adequately to glasses or other measures. The surgeon makes small adjustments to the muscles around the eye to bring it back into alignment. The procedure is done under general anaesthesia in children and often under local anaesthesia in adults. It is a short procedure and most patients go home the same day. It is important to understand that squint surgery corrects the alignment of the eye. If a lazy eye is also present, that needs to be treated separately through patching, as surgery alone will not restore the vision.
- Follow-up and Monitoring: Always part of the plan Whichever squint treatment is chosen, regular follow-up is important. The eyes of young children change as they grow, and the squint treatment plan may need to be adjusted along the way. Adults with an acquired squint also need monitoring to ensure the underlying cause is being managed.
Related Eye Conditions
• Lazy Eye (Amblyopia)
• Nystagmus
• Congenital Cataract
• Retinoblastoma
• Refractive Errors (Myopia, Hyperopia)
References
NHS. Squint (Strabismus): Overview, Causes and Treatment. Last reviewed May 2023. https://www.nhs.uk/conditions/squint/
Gunton KB. Advances in amblyopia: what have we learned from PEDIG trials? Pediatrics. 2013. https://pubmed.ncbi.nlm.nih.gov/23439899/
American Association for Pediatric Ophthalmology and Strabismus. Strabismus. https://aapos.org/glossary/strabismus
Hashemi H, et al. The prevalence of strabismus in the Middle East. Journal of Current Ophthalmology. 2019. https://pubmed.ncbi.nlm.nih.gov/31528764/
Cleveland Clinic. Strabismus (Crossed Eyes): Causes, Symptoms and Treatment. https://my.clevelandclinic.org/health/diseases/15065-strabismus-crossed-eyes
For appointments, call 1800 571 2222 or visit your nearest Vasan Eye Care centre.
What Happens If Squint Is Left Untreated?
Ignoring a squint, especially in a child, can lead to lasting problems. Here is what can happen:
Lazy eye (Amblyopia): This is the most significant risk. When one eye is misaligned, the brain begins to prefer the signals from the straight eye and gradually ignores those from the squint eye. Over time, the vision in the neglected eye weakens significantly. If this is not addressed before the age of 7 to 8 years, the vision loss can be permanent.
Double vision: Adults who develop a squint often experience double vision, which can interfere with reading, working, and driving.
Loss of depth perception: Good depth perception relies on both eyes working together. A squint disrupts this, making it harder to judge distances accurately for tasks like sports, driving, or pouring liquids.
Emotional impact: For children and adults alike, a visible squint can affect self-confidence. Children may be teased at school, and adults may feel self-conscious in social and professional settings. This emotional aspect of living with a squint should not be overlooked when considering whether to seek squint treatment.
Squint in Newborns: What Parents Should Know
It is quite normal for a newborn’s eyes to wander or cross occasionally in the first few weeks of life. The visual system is still maturing and learning to coordinate. However, after 3 months of age, both eyes should be pointing in the same direction most of the time.
If you notice that your baby’s eyes are consistently misaligned after 3 months, or if one eye appears to turn in or out regularly, get an eye examination done. Early squint treatment in infants can make a significant difference to how their vision develops.
A note for parents: Sometimes, young babies appear to have a squint because the way the skin folds around the nose bridge makes the inner whites of the eyes less visible. This is called pseudosquint and it is harmless. A doctor can confirm this during an examination. If in doubt, always get it checked.
Squint vs Lazy Eye: What Is the Difference?
These two conditions are often confused, and it is easy to see why they frequently appear together.
A squint is about the position of the eye. It means the eye is physically pointing in the wrong direction.
A lazy eye (amblyopia) is about the quality of vision. It means the brain is not using one eye as well as the other, which causes the vision in that eye to be weaker.
A squint can cause a lazy eye. When an eye is misaligned, the brain may start ignoring it to avoid confusion, and this leads to the vision in that eye deteriorating. But a lazy eye can also exist without a visible squint.
The reason this distinction matters is that squint treatment and lazy eye treatment are different. Surgery corrects alignment. Patching builds vision. A complete squint treatment plan often needs to address both.
Squint Care at Vasan Eye Care
At Vasan Eye Care, squint is one of the conditions we see and treat regularly across our network of 150+ centres in India. From the first check-up for a newborn to squint surgery for an adult, our team covers the full range of care.
When you bring your child or yourself to us for a squint, here is what you can expect:
- A thorough eye examination that assesses both the alignment and the quality of vision in each eye
- A clear explanation of the squint type and what is likely causing it
- A squint treatment plan made for your individual situation
- Honest guidance on whether glasses, patching, or squint surgery is the right next step
- Regular follow-up to track how the treatment is working and make adjustments if needed
- A caring, unhurried environment where you can ask as many questions as you need
Our 500+ eye care specialists and 5,000+ support staff across India are part of ASG Enterprises, India’s largest eye care network. We bring that collective clinical experience to every patient who walks through our doors.
Frequently Asked Questions (FAQs)
There is no single answer, as it depends on the type of squint, its cause, and the age of the person. For children with an accommodative squint, glasses are often enough. For more significant squints, surgery is a well-established squint eye treatment that gives good results for the right patients. Your eye specialist will assess your specific situation and recommend the most suitable squint treatment.
Yes, in certain cases. If the squint is caused by an uncorrected spectacle number, glasses can reduce or eliminate it. Patching helps treat the lazy eye that often comes with a squint. Eye exercises can support alignment in mild cases. However, not all squints respond to non-surgical methods, and surgery may be needed for the eyes to align properly. Your doctor will tell you honestly which route is appropriate for your situation.
In babies under 3 months, some eye wandering can be normal as the eyes mature. After this age, a persistent squint is unlikely to resolve on its own and should be evaluated. Waiting too long, especially in children, risks the development of a lazy eye and permanent vision loss in the affected eye. Early squint treatment gives much better outcomes than delayed intervention.
Squint surgery is a well-established procedure with a strong record of improving eye alignment. It significantly improves the position of the eye for most patients. Some patients may need more than one procedure over time, especially children whose eyes continue to develop. It is also important to remember that surgery corrects the position of the eye, but any lazy eye must be treated separately with patching to restore vision. Your doctor will discuss realistic expectations with you before proceeding.
The earlier, the better. The first 7 to 8 years of a child’s life are the most important for visual development. Squint treatment started within this window has a much higher chance of preserving good vision in both eyes. That said, squint surgery and other treatments can still improve eye alignment in older children and adults, even if the vision benefit is more limited.
Yes, squint does have a genetic component. If a parent, sibling, or grandparent had a squint, there is a higher chance of a child developing one. This does not mean it will definitely happen, but it is worth getting the child’s eyes checked early, even if no squint is obvious yet.
Quite possibly, yes. Squint surgery corrects the alignment of the eye, but it does not change the underlying spectacle number. If your child was wearing glasses before surgery, they will likely need to continue wearing them afterwards. The glasses and squint surgery work together as part of the overall squint treatment plan.
Yes. Adults can and do have squint surgery, and it is generally performed under local anaesthesia, meaning the patient is awake but comfortable during the procedure. For adults, the primary goals of squint eye treatment are to correct the alignment, reduce double vision, and improve quality of life. Many adults who have lived with a squint since childhood also choose surgery for cosmetic and psychological reasons.
