When a child’s eyes don’t align: 5 warning signs of squint every parent must know

It’s something many parents notice casually at first. A child looking sideways while watching TV, one eye drifting in photos, or a teacher mentioning that the child seems to “lose focus” while reading. Often, it gets brushed off, “they’ll grow out of it.” But in the case of squint, or strabismus, waiting is rarely the right approach.

“Squint simply means that both eyes are not looking in the same direction at the same time. One eye may turn inwards, outwards, upwards, or downwards. It may happen constantly or only when the child is tired or focusing on something specific. While it might seem like a cosmetic issue, it goes much deeper than appearance,” explains Dr Sridevi Haldar, Consultant Ophthalmologist at Dr Haldar’s OrthoVision Healthcare.

A real story that stayed

Ankit Kumar, a Class 11 student, came in with a concern that had quietly followed him for years, a visible squint in one eye. Interestingly, his vision in both eyes was good. The problem wasn’t clarity, but coordination. His eye muscles weren’t working together properly.

What affected him more than the condition itself was how people reacted to it. At school, he faced teasing and unwanted attention because of the way his eye looked. Over time, it chipped away at his confidence.

When Ankit consulted Dr Sridevi, she explained his condition in simple terms and reassured him that it could be corrected. That conversation itself made a difference. He went ahead with squint surgery, a straightforward procedure that balances the eye muscles. Today, his eyes are well-aligned, but more importantly, his confidence has changed. He smiles more easily now. And that shift is hard to miss.

Why does squint happen in children?

Dr Sridevi says there isn’t just one reason. In fact, squint can develop due to a mix of factors:

1. Developmental causes: Sometimes the eye muscles don’t develop perfect coordination. 

2. High AC/A ratio: In accommodative squint, the eyes turn inward while focusing. 

3. Anisometropia: When both eyes have significantly different power. 

4. High astigmatism: Blurred vision can affect alignment over time. 

5. Sensory causes: If one eye has poor vision due to retinal or other issues, it may drift. 

In many cases, the squint is actually a sign of an underlying vision problem. That’s why early evaluation is so important, it helps catch issues like refractive errors or even retinal conditions that might otherwise go unnoticed.

What should parents look out for?

Sometimes it’s obvious. Other times, it’s subtle. Dr Sridevi reveals signs parents should look out for:

1. Tilt their head frequently 

2. Close one eye in bright sunlight 

3. Struggle to maintain eye contact 

4. Complain of double vision (older children) 

5. Or simply appear to have “wandering eyes” in photos 

Even if it happens occasionally, it’s worth getting it checked. It’s better to be cautious than to miss the early window of treatment.

How is squint treated?

Treatment depends on the cause and severity. It’s not always about surgery, and many parents are surprised by that.

Common approaches include:

1. Correcting refractive errors with glasses 

2. Amblyopia (lazy eye) treatment, often using patching or eye exercises 

3. Vision therapy to improve coordination 

4. Surgery, when needed, to align the eye muscles 

Squint surgery, in particular, is often misunderstood. It’s not a complicated or risky procedure in most cases. It simply involves adjusting the eye muscles so that both eyes can work together again.

The one thing to remember

Squint does not correct itself with time. Waiting usually makes things harder. If left untreated, it can lead to amblyopia (lazy eye), where the brain starts ignoring input from one eye. And once that sets in, treatment becomes more challenging.

Dr Sridevi concludes, “Early attention can make all the difference, not just for vision, but for a child’s confidence, social comfort, and overall development. Because sometimes, fixing a squint isn’t just about straightening the eyes. It’s about helping a child feel seen, comfortable, and confident in their own skin.”

(This article is based on information available in the public domain and on input provided by experts consulted.)