Can Contact Lenses correct a squint?

Can Contact Lenses correct my child's squint?

A squint - known medically as Strabismus, which is derived from a Greek word meaning "eyes that look obliquely" and refers to misaligned eyes, is relatively common in children,  affecting around 5% of children in the UK, and is normally diagnosed before the age of 5, although this can be later.

In this post, we’ll share vital information on squints and what you could do to help a child with this disorder, there are many simple, proactive steps you could take to help squint sufferers see clearly. 

What Is A Squint?

Officially known as strabismus, squint is a relatively common visual disorder characterised by slight eye misalignment. Children with squint tend to have one eye that can focus very well and another that cannot. Often, squint patients have what looks like a “crossed eye” pointing towards the nose, but the misaligned eye could also focus too far up, down, or towards the ear. 

1. Congenital or Infantile Squint is where a baby is born with a squint 
2. Acquired squint - this is where the squint develops later in childhood, this may be due to the eye trying to overcome a problem such as short or long-sightedness.

Genetics may play a role in the development of squints but it is still not fully understood why many squints develop. According to Morefield's Eye Hospital only rarely is a squint caused by a condition of the eye itself.

A squint can present all the time or only obvious when a child is tired or focusing on objects close up

According to the Royal National Institute for the Blind (RNIB) 2-3 percent of children in the UK will have a squint. Although it is possible for adults to develop squint symptoms, generally this only happens as the result of direct trauma, a stroke, or some kind of neurological condition.

What Are The Signs Of A Squint?

The main signs of a squint will be the eye not acting uniformly, although some milder squints may not be noticeable to parents.  Some of the symptoms your child may complain about or you may notice are

• Headaches
• Eye pain
• Eye fatigue
• Squinting
• Turning the head sideways to view the TV or read
• Shutting one eye to read or watch TV

If a parent, carer, teacher etc notices any of these signs or symptoms in a child then they should arrange for the child to see an Optometrist for a sight test. 

What Types OF Squints Are There?

 There are four types of squint and they are categorised depending on the presenting factors

Esotropia
This is where one eye turns inwards towards the nose

Exotropia
This is where one eye turns outwards away from the nose

Hypotropia
This is where one eye turns downwards towards the cheek

Hypertropia
This is where one eye turns up towards the eyebrows

Can Contact Lenses Correct A Squint?

If you have a child suffering from the relatively common visual disorder squint, then you might be wondering whether contact lenses could help his/her condition. While contact lenses could play a role in a treatment protocol, they usually aren’t enough to completely reverse a squint. On top of wearing correctly fitted and prescribed contact lenses or glasses, Optometrists often recommend squint patients practice at-home eye exercises to avoid developing serious conditions like a lazy eye.

What Are The Most Common Treatments For a Squint?

After a patient is diagnosed with a squint, Optometrists will often refer the child to an Orthoptist who will take on the treatment and monitoring of a squint, they have many tools at their disposal to help reverse this disorder. The specific treatment regime your child receives will depend on his/her specific symptoms.

The three most common treatments prescribed to squint patients.

1. Wear Corrective Eyewear   

Many children who have a squint also have some type of refractive error such as myopia or hyperopia. If this is the case with your child, then the Optometrist will prescribe either eyeglasses or contact lenses to correct the vision. 

Usually, children with a squint have no issues wearing well-fitted prescription soft contact lenses, but there are a few specialised glasses with prism lenses that can control the degree of the squint, and these cannot be included in contact lenses. Your Optometrist might prefer using prism lenses to help gently train your child’s weaker eye. 
Whether or not your child needs prism eyeglasses depends on the severity of their squint. As always, ask your optometrist what they recommend for your child’s condition.

2. At-Home Eye Exercises 

On top of corrective eyewear, squints are often treated with a few at-home eye exercises. Be sure your child understands the correct technique and practices the exercises as prescribed for optimal results. 

A commonly taught exercise involves attaching a string to a door handle with three differently coloured beads in the centre. Children are asked to focus on each of the beads and tell their Optometrist what they see. If their eyes are focusing properly, then all three coloured beads should form an “X” pattern. Children who don’t see the “X” must change the placement of the beads until they achieve visual clarity. 

3. Wearing A Patch

Wearing a patch or occlusion therapy is a common form of treatment for a squint often along with other glasses and or eye exercises.

It may be surprising to know that the patch is worn on the good eye, by covering the good eye it makes the weaker eye work a little harder in building links between the eye and the brain, effectively allowing the vision in the weaker eye to catch up, if this is undertaken soon enough the weak eye can improve to normal levels.

4. Surgery

Some squints may require surgery on the eye muscles to straighten a squint, particularly if the squint is very noticeable and is not responding to other treatments such as glasses or occlusion.

Squint surgery is a quick procedure performed under general anaesthetic and normally performed as a day patient so no overnight stay. According to the RNIB surgery can not improve the level of vision in the lazy eye, so glasses and or patching may still need following surgery.

What Is A Convergent Squint?

A convergent squint is when one eye turns inwards towards the nose and is the most common type of squint in children. It is almost always caused by uncorrected long-sightedness in children.

A convergent squint will usually correct just as well with contact lenses as with spectacles. However, if vision is bad in the squinting eye, it may not straighten with spectacles or with contact lenses.

The convergent type squint is caused by the need, due to congenital focus error, of excessive efforts in very early infancy to focus on far objects and this is almost impossible to do without corresponding eye convergence. (The focus and convergence are linked.) 

This leads to the 'crossing' of the visual axes and so the vision of one eye has to be 'suppressed' whilst the other continues to be pointed at the object which would otherwise be seen as double. (Divergent squint is the opposite, there being no need to focus near things the convergence is suppressed leading to an eye pointing outwards and this does not correct so well).

Relieving the need to focus usually relieves the tendency to convergent squint at least as well as with spectacles and in some cases, people will relax and accept more focus help from contact lenses than from spectacle lenses.

What Is A Lazy Eye?

Lazy eye, medically known as amblyopia, is a condition found in children where vision does not develop correctly, normally causing one eye to become so weak that it can no longer accurately see clearly, even with corrective eyewear.

According to the NHS it is estimated that 1 in 50 children will develop a lazy eye, as it is difficult to see a lazy eye they are often first noticed in a regular eye test. 

Children can be tested at your high street opticians by an Optometrist from around 3 years of age. Although all babies have an eye test within a few days of birth and again at around 3 months this is to check for conditions such as congenital cataracts. Children's visual problems such as squints, short or long-sightedness may not develop until they are a few years old. Typically squints develop around early school age, when the eyes start to get used more intensely up close.

A Lazy eye will often develop if strabismus (Squint) is not treated early enough so the sooner treatment for a squint begins the better the outcome.

It is difficult to treat a lazy eye after six years old this is why most councils throughout the UK arrange for children between 4 and 5 to have a basic eye test.

Amblyopia treatment can be time-consuming and involves wearing an eye patch every day. Without prompt treatment at this stage, however, children run the risk of permanently losing vision in their weak eye. 

Besides the visual consequences, children who grow up with an untreated squint often struggle academically and socially, often becoming shy and self-conscious, so it is important not to ignore a squint, a few months of patch-wearing whilst small may seem unfair but the benefits will last a lifetime.