Assessment for inward, outward and vertical eye turns

Childhood Squint and Strabismus Treatment in Sydney

A squint — where the eyes don’t point in the same direction at the same time — is one of the most common reasons parents bring their child to see an eye specialist. It affects around 1 in 20 children.

What is strabismus?

Strabismus happens when the muscles controlling eye movement don’t work together properly, so one eye turns in, out, up or down while the other looks straight ahead. It can be constant or come and go, and may be more noticeable when a child is tired, unwell or concentrating closely on something.

Common types

• Esotropia — an eye turning inward, the most common type in young children
• Exotropia — an eye turning outward, often more noticeable when a child is daydreaming or tired
• Vertical strabismus — an eye turning up or down, less common

What causes it?

In many children there’s no single identifiable cause — it relates to how the eye muscles and the brain’s control of eye alignment develop. Strong long-sightedness, a family history of squint, prematurity and certain neurological or genetic conditions can all increase the likelihood.

Why it matters beyond appearance

A squint isn’t just a cosmetic issue. When the eyes aren’t aligned, the brain may suppress the image from the turned eye to avoid double vision — which can lead to amblyopia (lazy eye) if untreated. Alignment also affects depth perception and binocular (3D) vision.

Diagnosis

Assessment involves observing eye alignment and movement, testing vision in each eye, and often dilating the eyes to check the full glasses prescription, since correcting long-sightedness can sometimes resolve or reduce a squint on its own (this is called accommodative esotropia).

Treatment options

Treatment depends on the type and cause:

• Glasses — can fully correct some squints, particularly those linked to long-sightedness
• Patching or drops — used if amblyopia has developed alongside the squint
• Eye muscle surgery — adjusts the muscles to realign the eyes when glasses alone aren’t enough

Surgery is a well-established, generally day-only procedure, and many children resume normal activities within a few days.

When to see a specialist

Any noticeable turn in a child’s eye — even intermittent — is worth having assessed. A squint that develops suddenly, especially in an older child, should be reviewed promptly, as it occasionally signals an underlying issue requiring urgent attention.

Our team at Bright Sight Eye Specialists can assess your child’s eye alignment and talk you through the right treatment path for their situation.

Book a paediatric eye consultation

For specialist children’s eye care in Randwick, contact Bright Sight Eye Specialists to arrange an appointment.

This information is general and does not replace an individual medical assessment.