What is strabismus (squint)?
Strabismus is a common condition where the eyes do not look together in the same direction. Whilst one eye looks straight ahead, the other eye turns to point inwards, outwards, up or down.
A squint develops when the eye muscles do not work in a balanced way and the eyes do not move together correctly. The squint can be present all the time (constant), or come and go (intermittent).
About 1 in 20 children over the age of three months have a squint (or have had one treated). A child with a squint may stop using the affected eye to see with, which can lead to visual loss called amblyopia; if it is not treated before the age of about seven years, the visual impairment usually remains permanent.
How strabismus affects vision
When the two eyes are not pointing in the same direction, the result is likely to be double and blurred vision. To stop this happening, the brain naturally suppresses the image from the weaker eye and relies on the better eye.
This reduces the ability of one eye to see as sharply as the other and can lead to the development of a ‘lazy eye’ or amblyopia. This can lead to permanently reduced vision.
This means that children and young people may have trouble with:
- close work and seeing fine details
- poor distance vision, including seeing the board, teacher demonstrations or finding their friends in the playground
Children and young people with a squint will have reduced binocular vision. Normally, both eyes look and focus on the same spot. The brain combines the signals from the two eyes to form a three dimensional image. For those with a squint, the two eyes focus on different spots.
This means the child or young person may:
- not be able to see properly in three dimensions
- need support with tasks such as catching a ball, going down steps or threading a needle as judging depth, distance and speed will all be difficult
- not be able to judge the height of steps
- not be able to each accurately for objects
- have difficulties judging how far away an object is
- be more likely to bump into things or fall when in unfamiliar places
- miss objects or people approaching
What can be done to help
Strabismus can be cosmetically corrected by surgery and may also restore some vision if done early enough. Glasses can help improve vision.
Education strategies for children and young people with strabismus
Children and young people with strabismus may need:
- clearly presented curriculum materials with a good contrast between text and background and, possibly, enlarged or modified
- additional time to complete visually challenging tasks
- encouragement to use glasses, contact lenses and low vision aids – this will make sure the vision parts of the brain grow and develop
- their own copies of learning materials rather than sharing with a partner
- you to consider screen sharing software
- good levels of task lighting, controlled by blinds or curtains to avoid glare – the child or young person should sit with their back to the light
- additional time for examinations
- support with certain play activities, using stairs or PE as they may have trouble judging depth and speed
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