What is a squint?

A squint is also known medically as strabismus. It is when one eye either wanders inwards or outwards. It can alternate and be sometimes the right eye or sometimes the left eye or be uniquely just one eye is turned in or out. It can be constant or part of the time. Now that may sound quite complicated, but actually, the whole area of squint or strabismus is a well-established part of Ophthalmology. The ophthalmologist works with someone called an orthoptist, who is a specially trained clinical professional who can measure the vision extremely accurately in adults and children, and also, measures squint and determine the amount that the two eyes work together.

We can learn a lot about squint from the orthoptic examination in children and adults and then advise the patient on whether medical treatment or surgery is needed.

Actor Ryan Gosling’s strabismus (exotropia) gives him a distinctive look.
To recap, squint is when one eye wanders inwards or outwards, and often the eyes appeared not to work together. This can be associated with head tilting or head turning, and it represents an eye muscle imbalance.
The eyes have little muscles that move them upwards, downwards, sideways and diagonally, so that we have got excellent movement of the eyes through 360 degrees, clearly more horizontally and downwards than upwards. However, when there is a squint or strabismus, there is an imbalance, and the eyes cross in or turn out.

Crossing in eyes are called crossed eyes or esotropia and turning out eyes are called wall eyes or exotropia. If it is only an intermittently turning in or turning out eye, then instead of the word tropia, we use the word phoria, such as esophoria or exophoria. Phoris are often seen when the patient is very tired.
It makes complete sense that if two eyes are not looking together at an object, that the quality of the vision is going to very likely be suboptimal because the eyes cannot track together in a co-ordinated way.

A patient with a squint can have a lazy eye, have blurred vision, sometimes experience double vision, or even vision loss, therefore squint does require investigating. Most importantly, a squinting eye can sometimes represent a serious pathology particularly in a child where there may be an undetected cataract or other abnormality.

At Clinica London, we are extremely fortunate in having Ms Naz Raoof as our paediatric ophthalmologist, who works together with Joe McQuillan and Gina Harris who are the two orthoptists who work at Clinica London. Ms Raoof sees children and adults with a squint. Over the next few blog posts, we will be talking more about the consequences of having a squint in a child. We’ll also discuss assessing and treating adults with squints at Clinica London.