About 1 in 20 children over the age of three months have a squint (or have had one treated). Causes include the following.

Congenital squints of unknown cause

Congenital squint means that the child is born with a squint, or it develops within six months of age. In most cases, the cause is not known. (The eye muscles are not balanced but the reason for this is not known.) In most cases one eye turns inward. This is called congenital esotropia (sometimes called infantile esotropia). This common type of squint tends to run in some families so there is some genetic component to this type of squint. However, many children with congenital esotropia have no other family members affected. In some cases the eye turns outward (congenital exotropia). Less commonly, a squint of unknown cause may result in an upward or downward turn of the eye.

Squint related to refractive errors

Refractive errors include: short sight (myopia), long sight (hypermetropia) and astigmatism. These are conditions that are due to poor focusing of light through the lens in the eye. When the child with a refractive error tries to focus to see clearly, an eye may turn. This type of squint tends to develop in children who are two years or older, in particular in children with long sight. The squint is most commonly inward looking (an esotropia).

Other causes

Most children with a squint have one of the above types of squint and are otherwise healthy. In some cases, a squint is one feature of a more generalised genetic or brain condition. For example, a squint may develop in some children with cerebral palsy, Noonan syndrome, hydrocephalus, brain injury, and various other conditions.

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