ABSTRACT
Squints (strabismus) affect 5% of children. A squint is an abnormal alignment of the eyes which prevents the occurrence of single binocular vision. Pseudosquints may occur if the child has wide epicanthic folds. Squints are usually concomitant in children, i.e. the angle of squint is the same in all directions of gaze. If the squint is incomitant (paralytic), eye movement is impaired due to a defective extraocular muscle and the angle of squint alters with different positions of gaze, or with changes of fixation. Manifest squints are readily apparent at examination and are demonstrated by the cover test. Latent squints are detected at times of tiredness or stress, or by specific clinical examination (alternate cover test). Early detection of squints is important for the diagnosis of treatable causes, e.g. cataracts, and to prevent the development of amblyopia. Squint is more common in children with Down’s syndrome, prematurity, cerebral palsy, and other neurological disorders. There is often a family history of strabismus.
