Strabismus means the eyes do not point in the same direction. Its cause and treatment differ in children and adults.
What is strabismus?
Strabismus, also called a squint, means the eyes are not aligned. One eye may turn inward, outward, upward or downward. The turn can be constant or intermittent. It occurs in children and adults and may affect how the eyes work together. NHS overview
Symptoms and urgent warning signs
A visible eye turn, an unusual head position or closing one eye can be clues. Adults may notice double vision. Children may not report seeing two images because the developing brain can suppress the view from one eye.
Sudden double vision or a new eye turn needs urgent assessment. Double vision after a head injury, or with a severe headache or enlarged pupil, needs emergency care immediately. Do not wait for a routine appointment. NHS double-vision guidance
Causes and associated conditions
In children, strabismus may relate to focusing needs, family tendency or the way eye movements are controlled. In adults, it may reflect a childhood condition or develop because of nerve, muscle, thyroid or other health problems. New adult misalignment requires investigation of its cause. AAPOS strabismus information | AAPOS adult strabismus
Strabismus and amblyopia are different. Amblyopia is reduced vision from abnormal childhood visual development; misalignment can cause it, but the two are not interchangeable. AAPOS
How is it assessed?
Assessment considers the onset and pattern of the turn, vision and focusing needs, and how the eyes move and work together. Children need assessment of visual development as well as alignment. Adults with a new problem may need further medical tests or scans according to the examination. Bring previous glasses and describe whether double vision began suddenly or gradually. NHS | AAPOS adult assessment
General treatment options
Treatment can include glasses, prisms to help selected cases of double vision, exercises for certain coordination problems, injections or eye-muscle surgery. The appropriate option depends on the type and cause. Exercises are not a universal treatment for every squint. Children with amblyopia may also need separate treatment to support vision in the weaker eye. AAPOS | AAPOS adult treatment
Surgery changes the position or action of eye muscles to improve alignment. It may be considered when other measures are unsuitable or insufficient. Discuss realistic goals, risks, recovery and whether further treatment might be needed. Straightening the eyes does not automatically restore reduced vision from amblyopia. NHS surgery information
Strabismus: Eye Alignment in Children and Adults illustrated
Questions for your appointment
- What type of misalignment is present, and what may be causing it?
- Is vision reduced in either eye?
- Would glasses, prisms or another treatment help my specific problem?
- What improvement is realistic, and how will it be measured?
Frequently asked questions
Should I wait for my child to grow out of a squint?
A constant turn, or one that continues intermittently after early infancy, should be assessed. Do not delay because the child seems to see well. NHS
Can adults receive treatment?
Yes. Options depend on the cause, symptoms and examination findings. AAPOS
Does wearing a patch straighten the eyes?
Patching is generally used to treat associated amblyopia; alignment may need a separate plan. NHS
This page is general education and cannot identify the cause of eye misalignment.
Sources and further reading
General educational information prepared October 2026. Treatments described are general options; availability and suitability require an individual assessment.
