Squint

It's quite common for newborns to have eyes that appear to squint or cross occasionally during the first few months of life. This is usually due to their eye muscles still developing and learning to work together.

Here's what you should know:

• Normal or Temporary Squint

  • In newborns (up to about 3–4 months), occasional squinting can be normal as their eye muscles are still developing.

  • Transient squints that occur rarely and correct themselves quickly are usually harmless early in life.

• Types include:

  • Esotropia: Eye turns inward

  • Exotropia: Eye turns outward

  • Hypertropia: Eye turns upward

  • Hypotropia: Eye turns downward 

• Timeline for Resolution: 

  • In most cases, this intermittent squinting tends to reduce by the time your baby is 2 months old

  • and typically disappears by 4 to 6 months of age.

• When to Seek Advice: It's important to consult a doctor if you notice any of the following:

  • Squint seen after 4 months of age

  • The squint is constant (present all the time) at any age.

  • Intermittent squinting persists or worsens after 2 months of age.

  • Your baby is older than 3 months and has a squint that comes and goes.

  • Child tilting their head or squinting frequently

• Possible Causes of Persistent Squint:  (called strabismus)

  • Problems with the eye muscles themselves.

  • Vision problems like farsightedness.

  • Neurological issues.

  • Genetic / Family history of strabismus.

  • Rarely, more serious conditions like cataracts or tumors

• Importance of Early Detection: 

If untreated, a squint can cause:

• Amblyopia ("lazy eye") — where the brain ignores signals from the misaligned eye

• Permanent vision loss in that eye

• Depth perception problems

• Cosmetic concerns and self-esteem issues later on.

Diagnosis

• Pediatrician or pediatric ophthalmologist assessment

• May involve tests like light reflection tests or pupil response exams

Treatment Options

• Glasses (for refractive errors)

• Patching the stronger eye (to force the weaker eye to work harder)

• Eye drops

• Eye muscle surgery (in some cases)

• Eye exercises

• Botox injections (sometimes used)

 So, while occasional squinting in the first few months is often normal, it's always best to discuss any concerns you have about your baby's eyes with their pediatrician. They can assess the situation and recommend an eye specialist if needed.

Here’s a simple treatment timeline for a baby or young child with a concerning squint:

🍼 0–4 Months

• Occasional squinting is usually normal.

• Monitoring only unless the squint is very obvious, constant, or associated with other issues (like droopy eyelid, unusual pupil appearance).

🍼 4–6 Months

• Persistent squint needs evaluation by a pediatrician or pediatric ophthalmologist.

• Eye exam is done to check vision, eye health, and alignment.

🍼 6–12 Months

• If squint is diagnosed:

  • Glasses may be prescribed if there’s a significant refractive error (like farsightedness).

  • Patching might be started if amblyopia (lazy eye) is detected (patching the good eye to strengthen the weaker eye).

  • Follow-ups every few months.

🧒 1–2 Years

• If no improvement or if the squint is large:

  • Surgical planning may begin.

  • Eye muscle surgery may be done to realign the eyes.

• Continued patching and/or glasses as needed.

🧒 2–7 Years

• Critical period for vision development.

• Regular follow-ups: every 3–6 months.

• Adjustments to glasses prescription, patching regimen, or more surgeries if necessary.

⏰ Key Points

• Early intervention = better outcomes.

• Vision therapy (eye exercises) may also be recommended after surgery.

• Some children may require more than one surgery or long-term glasses.