Living with strabismus

Strabismus is a common childhood eye condition, occurring in about 2% of children (Source: Archives of Pediatric and Adolescent Medicine).

A squint is often spotted first by parents who notice their child's crossed eyes. It's natural to worry if your child is diagnosed with strabismus because it can lead to complications such as a lazy eye. As it's often noticeable to other people, children can also feel self-conscious about having such a visible difference.

Fortunately, early diagnosis and treatment can be very effective, and your child could have an excellent quality of life with no lasting loss of vision due to strabismus. Even people who develop a squint for the first time as adults can have treatment.

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Managing your squint

After diagnosis, there are various treatment options for correcting a squint. Children may need encouragement and support while being treated for strabismus. Just as having eyes that look in different directions can make them feel self-conscious, treatments such as wearing glasses and using an eye patch (to correct a lazy eye caused by strabismus) can be tricky for children to adjust to.

Your child's optician should help you choose glasses frames that are the right fit for your child. Ensuring they're comfortable will make it easier for your child to wear them. Involving your child in the choice can help them towards accepting them. Praise and encourage your child for wearing them, especially at school and during active times such as doing sport and playing with friends.

If your child is a bit older, they may have eye exercises to practise at home. Also known as 'orthoptic vision therapy', this aims to improve eye movement control by exercising eye muscle control.

Your child will have follow-up appointments to monitor how well treatments are working. Even after treatment ends, regular eye examinations are important to care for eye health and diagnose any eye diseases as early as possible. The NHS recommends everyone has an eye test every two years.

When strabismus is diagnosed early in children, treatment can correct their squint and prevent future vision problems such as a lazy eye. This treatment may be sufficient to deal with the condition. Sometimes, adults who've had treatment for strabismus as children may need corrective surgery again as adults if the misalignment of the eyes returns.

Driving with strabismus

Your eyesight must meet the DVLA's minimum required standard to drive. Many people with strabismus will have good enough vision for driving. Even if you have amblyopia, if the vision is good enough in your other eye, you may be able to drive.

The exception to this is when a squint causes double vision (diplopia). Having double vision means you see two images at once, making it unsafe for you to drive. You have to tell the DVLA if you have an eye condition that affects your driving, including double vision. If your ophthalmologist can help you get the double vision under control, for example, by treating your squint with prism eyeglasses, you may be able to drive. It can take time to adjust to these, so speak to your eye doctor for advice before driving again.

Can you work with a squint?

With early diagnosis and treatment, complications and vision problems like a lazy eye can be prevented. This means it shouldn't impact your ability to do a wide range of jobs, just as for people without strabismus.

If strabismus causes vision problems in adulthood, you may find adjustments at work can help you make the most of your vision. Many tools and tips can help, for example, assistive technology and visual aids.

People who develop a squint for the first time as adults may need some time off work to adjust to symptoms of strabismus such as double vision and for treatment such as corrective surgery. It's often a good idea to tell your employer about your condition and the support you need. Under the Equality Act, employers must support staff with vision problems.

Strabismus help and support

You or your child will probably be referred to an orthoptist, a specialist in hospital eye clinics. Orthoptists are very experienced in assessing children's sight and often prescribe treatment, such as giving eye exercises. You can ask them for advice about supporting your child or helping your child understand their condition and treatment.

You or your child will probably also see an ophthalmologist - a hospital eye specialist - for diagnosis and treatment such as corrective surgery.

For anyone, being diagnosed with an eye condition can be a worrying time. It's often helpful to speak to other people with shared experience who understand how you may be feeling. Our Guide Line can put you in touch with support groups and support.

Children with a squint may have some challenges, such as issues with self-esteem from having a visible difference. They may also have some vision problems before diagnosis and before treatments take effect, for example, having to use their weaker eye more for schoolwork.

We can help you get educational support for your child. When preparing to start school or after diagnosis, talk to their teacher. Explain your child's condition so they know how it affects them and what adjustments they might need.

Children may feel self-conscious about having a squint. Getting support can help grow their confidence and self-esteem. We offer family support at every stage of their development.

It can help to meet other parents and families living with strabismus. They tend to understand what it's like and can be great for emotional support. Contact us for advice on finding support groups.

Frequently asked questions

Having a squint is not usually considered a disability unless it significantly affects how you go about day to day life.

Childhood strabismus that isn't treated can lead to a lazy eye, with vision loss in the affected eye. If your vision in the other eye is good, this is unlikely to cause a disability. However, if you develop an eye condition later in life or experience injury to the eye with good vision, this could make life more challenging than for someone without strabismus.

If you have an eye condition like strabismus that isn't a disability, you can still get help and support. Call our Guide Line to get advice and learn more about how we can help you or your child.
In children whose strabismus isn't treated, the brain may start to ignore the images it gets from the weaker eye to overcome double vision (diplopia). This can lead to a lazy eye (amblyopia), with poor vision in the eye that squints. Other symptoms can include eye strain and headaches, poor depth perception, and sometimes lack of confidence due to the appearance of the squint. Treatment can help avoid these complications.
Although most people with strabismus have it from childhood, it can happen in adulthood too. Causes of adult strabismus include health problems such as stroke, brain tumour, thyroid disease, and injury. The treatment options for adults with strabismus include prism eyeglasses, eye exercises, botulinum toxin injections, and strabismus surgery.

Get in touch

You can contact us to find out about services and support tailored to your individual needs.

Medically reviewed by: The Royal College of Ophthalmologists on 28/07/2022

Edited by: Nick Astbury FRCS FRCOphth FRCP
Clinical Associate Professor
LSHTM

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.

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Strabismus (squint)

Living with strabismus (squint)