Understanding Squint Correction in Children: What Parents Need to Know

Noticing a squint in your child’s eye can be worrying, but it’s also more common than many parents realise and can occur in an otherwise healthy, normal child. Whether it’s visible in photos, happens only when they’re tired, or is present all the time, a childhood squint (also known as strabismus) can affect how the eyes work together and how clearly your child sees the world.

We spoke to Mr Marcus Posner, Consultant Ophthalmologist, at St John & St Elizabeth Hospital, who shares her insight into how squints can affect children’s vision and confidence and how early treatment through our same-day paediatric service can help improve the alignment of the eyes and support healthy development. As well as specialising in paediatric ophthalmologic surgery such as squints, he has a thriving practice for adult eye conditions such as cataracts.

While some squints may improve with glasses, others may need a straightforward procedure to gently reposition the eye muscles and improve the alignment of the eyes. With early treatment, it’s often possible to improve vision and prevent the brain from relying only on the stronger or unaffected eye.

Does My Child Need Treatment?

Not all squints need immediate surgery, but most children with a visible or persistent squint will benefit from early assessment by an eye specialist. Even if the squint seems mild or only appears occasionally, it can still affect how your child’s eyes work together and may impact their long-term vision if left untreated. It is important to examine your child’s visual system to ensure the squint is not a result of an underlying disorder.

You might notice a squint in photographs when your child is tired, or when they’re focusing on something close up. Other signs include:

• Tilting their head to one side
• Closing one eye in bright light
• Complaining of double vision
• Poor coordination or depth perception

It’s also advisable to have your child’s vision assessed if there is a family history of squint or amblyopia (also known as lazy eye)

Treatment depends on the type, severity, and cause of the squint. For some children, glasses or eye drops may help correct the problem. Others may need eye exercises or, in some cases, squint surgery to adjust the position of the eye muscles.

Acting early can reduce the risk of the brain ‘ignoring’ the affected eye, which can lead to permanent vision loss in that eye. The sooner your child is seen, the more likely it is that treatment will be simple and effective, often avoiding the need for further surgery later on.

How Is a Squint Diagnosed?

If your child is showing signs of a squint, they’ll usually be referred to an eye specialist for a detailed assessment. The aim is to confirm the type of squint, check how well both eyes work together, and understand whether the vision in one eye has been affected. At the appointment, your child will be seen in a paediatric clinic setting, and several tests may be carried out, depending on their age and how the squint presents.

These may include:

• Vision tests to assess each eye separately
• A cover test, where one eye is briefly covered to see how the other responds
• Checking the alignment of the eyes and eye muscle movement
• Refraction testing to check whether glasses might help
• Use of eye drops to dilate the pupils and examine the health of the eyes more closely

These tests are safe, quick, and designed to make children feel comfortable. A pre-operative assessment will also be arranged if squint surgery is recommended, which allows the team to check overall health and readiness for a day case procedure.

The earlier a squint is diagnosed, the easier it is to treat, often before it starts to significantly affect your child’s vision or confidence.

What Are the Treatment Options Squint in Children?

Treatment for a child’s squint depends on its cause, severity, and how much it affects their vision. In many cases, early intervention can improve the alignment of the eyes and reduce the chance of long-term complications.

Common treatment options include:

Glasses
If the squint is related to a refractive error (such as long-sightedness), wearing glasses can help correct the alignment and may reduce or even manage the squint without further intervention.

Eye Exercises
For some types of squint eye exercises may help strengthen coordination between the eyes, particularly if the squint is intermittent or mild.

Squint Surgery
When glasses or non-surgical treatments aren’t enough, squint surgery may be recommended. This involves adjusting the position of the eye muscles to improve alignment and help both eyes work together.

At St John & St Elizabeth Hospital, squint correction in children is typically performed as a same-day procedure through our paediatric day case unit. Most children are able to go home a few hours after surgery.

Even with successful treatment, some children may need further surgery later in life, particularly if the squint changes as they grow. Ongoing reviews help monitor vision and eye alignment as your child develops.

What to Expect from Squint Surgery

Squint surgery is a routine and safe procedure, especially when performed in childhood. It involves adjusting the eye muscles to improve the alignment of the eyes so they can work together more effectively. Squint surgery may be required in one eye alone or occasionally in both. The surgery is tailored to your child’s individual needs.

What happens during the procedure?

The surgeon makes a small incision on the surface of the eye to reach the eye muscles. They are then repositioned slightly to improve alignment. The procedure typically takes around 30 to 60 minutes, and dissolvable stitches are used so there’s no need for removal.

Your child will wake up in the recovery area and can usually go home the same day, once they’ve had something to eat and are feeling comfortable.

What should parents expect afterwards?

The eye may look red or sore for a few days, and there might be mild discomfort, but this usually settles quickly. Children can return to normal activities, including school, within one to two weeks, though they’ll need to avoid swimming and rough play for a little while.

You’ll be given guidance on:

• How to use any prescribed eye drops
• Signs of infection or complications (which are rare)
• When to come back for a review in the clinic

The result will be immediate, however there can be a mild change over a few weeks during healing for it to be fully visible. Some children may need further surgery later on, particularly if there’s an overcorrection or if the squint returns as they grow. Regular follow-up ensures any changes are picked up early.

Life After Squint Correction

Most children recover quickly after squint surgery and can return to school and other normal activities within a couple of weeks. The eye may appear red or slightly swollen at first, but this usually improves within days.

The eye commonly will appear slightly more closed for up to 4 weeks, this is quite normal and will settle. It is common to have the appearance of a bruise on the surface of the eye.

A pad is placed over the eye until the morning after the procedure. This improves comfort. Usually only Calpol is required for relief of discomfort and this is rarely required beyond the first 24 hours.

A child can safely use their eyes to read or screen use straight after surgery. It’s also common for children to feel a little tired or clingy the day after the procedure; this is completely normal.

What changes should parents expect?

In most cases, the alignment of the eyes will look noticeably improved within the first few days. Some children may still need glasses or monitoring depending on their underlying vision needs. If a lazy eye is present, continued treatment to improve vision in the affected eye may still be needed after surgery.

Follow-up appointments will be arranged to monitor healing and check that the eyes work well together in their new position. Occasionally, the squint may reappear over time, or a slight overcorrection may occur. If this happens, your child’s consultant will discuss whether further surgery is needed in the future.

Helping your child adjust

The emotional benefits of squint correction can be just as important as the physical ones. For many children, improved eye alignment boosts confidence, especially in social settings or at school. Children who once tilted their head, closed one eye, or avoided eye contact often feel more comfortable and at ease after treatment.

If you have any further questions after surgery, your care team is available to offer advice and reassurance. Our team at St John & St Elizabeth Hospital works closely with parents and carers to ensure every child’s recovery is smooth, supported, and closely monitored.

If you’re concerned about your child’s squint or vision, our Paediatric Clinic offers expert assessment and same-day squint correction through our dedicated day case unit. Speak to our friendly team today to find out how we can help.

Children’s Squint Correction FAQ’s

Can a lazy eye be corrected in kids?
Yes, a lazy eye, or amblyopia, can often be successfully treated in children, especially when caught early. Treatment may include wearing glasses, using eye drops, or patching the stronger eye to encourage the weaker eye to work harder. In some cases, squint surgery may be recommended if the eyes are not properly aligned.

What causes kids to have a lazy eye?
A lazy eye usually develops when the brain starts to favour one eye over the other. This can happen if there’s a squint, a significant difference in glasses prescription between the two eyes, or something blocking clear vision, like a droopy eyelid.
Without treatment, the brain may ‘ignore’ signals from the affected eye, leading to slower or reversal of development of vision in children.

What to do if I think my child has a lazy eye?
If you’ve noticed your child squinting, turning their head to see, or favouring one eye, it’s a good idea to book an appointment with an eye specialist. Early assessment is key; the sooner treatment begins, the more likely it is to restore or improve vision in the weaker eye.