Squint

Squint (strabismus) is characterised by misalignment of the visual axes. Squints may be divided into concomitant (common) and paralytic (rare). It is important to detect as uncorrected may lead to amblyopia (the brain fails to fully process inputs from one eye and over time favours the other eye).

Concomitant	Paralytic
Due to imbalance in extraocular musclesConvergent is more common than divergent	Due to paralysis of extraocular muscles

Detection of a squint may be made by the corneal light reflection test - holding a light source 30cm from the child's face to see if the light reflects symmetrically on the pupils

The cover test is used to identify the nature of the squint

ask the child to focus on an object
cover one eye
observe movement of uncovered eye
cover other eye and repeat test

Management

referral to secondary care
- eye patches may help prevent amblyopia