Paediatric Strabismus


A squint is a condition where your eyes look in different directions. One eye turns inwards, outwards, upwards or downwards while the other eye looks forwards. The medical name for a squint is strabismus.

The misalignment of the eyes can be caused by different factors. It can be an early developmental problem where the brain struggles to identify that the two eyes should work as a pair. It can be caused by an abnormality with the eye muscles or an uncorrected vision problem, such as myopia (shortsighted), hypermetropia (longsighted) or Astigmatism.

When to see a doctor?

Squints in children are relatively common. They usually develop before a child is five years of age, but they can appear later.

Up to around three months of age, many babies occasionally squint as their vision develops. This is normal and nothing to worry about. If your child still has a squint after this age, you should visit your Doctor. It is very important that a squint is picked up and treated as early as possible to avoid vision problems developing. If a squint is identified when a child is young, there is a good chance that it will be successfully treated.

Can adults get a squint?

Occasionally, squints that have been corrected during childhood reappear in adulthood. New squints in adults, without any history of a squint in childhood, can be caused by problems with the ocular muscles and/or the eye movement system. You should visit your Doctor as soon as possible if you develop a new squint. They should refer you to an ophthalmologist who will carry out an examination to identify the cause.

Squints that affect adults may cause double vision because the brain has been trained to collect images from both eyes. Squints may also cause a cosmetic problem in adults; in such cases, the appearance of a squint can lead to low self-esteem

What is Amblyopia?

Amblyopia is also known as a ‘lazy eye’. Amblyopia is an early childhood condition where a child’s eyesight in one eye does not develop as it should. The problem is usually in just one eye, but can sometimes affect both of them. Amblyopia affects approximately 2% of children.

When a patient has amblyopia the brain focuses on one eye more than the other, virtually ignoring the ‘lazy eye’. If that eye is not stimulated properly the visual brain cells do not mature normally.

What causes a ‘lazy eye’?

Anything that interferes with clear vision in either eye during the critical period (birth to 6 years of age) can cause amblyopia. The most common causes of amblyopia are constant strabismus (constant turn of one eye), anisometropia (different vision/prescriptions in each eye), and/or obstruction of an eye due to cataract, trauma, lid droop, etc.

Why does my child need to wear a patch?

Occlusion (patching) is used to make a lazy eye work on its own and so improve the vision by encouraging the development of the nerve pathways from that eye to the brain. The patch is worn over the good eye and the amount of time the patch must be worn is decided by the Orthoptist/Ophthalmologist and relates to the extent of the visual problem. If patching is implemented early on, a good level of vision can be achieved. When patching is started in an older child, it is more difficult to achieve good vision.

What is an Orthoptist?

An Orthoptist specialises in diagnosing and treating visual problems involving eye movement and alignment.

The Orthoptist at Moorfields Dubai provides clinical support to all the specialist services at the hospital. She sees both adults and children who have strabismus (a squint), disorders of eye movements, or binocular vision.

What is an Optician?

An Optician will see adults and children for refraction; with this assessment, an optometrist can determine the optical power of the eye, the presence of any “refractive” error that requires spectacle correction, and the best vision that an eye can achieve with an appropriate correction. Younger children have drops to make the pupil (the dark center of the eye) larger and this makes the test more accurate.

What is an Ophthalmologist?

An Ophthalmologist is a specialist in medical and surgical eye problems. Since ophthalmologists perform operations on eyes, they are considered to be both surgical and medical specialists. They will check both the structure and health of the eye. They will make the final decision on the management and will do any surgical procedures required.