This is a question we get fairly often from parents. “My neighbour’s child had a squint and wore glasses for a couple of years. My baby has the same thing — will it be exactly the same?” Not necessarily. Let us walk you through what we actually know about how squint behaves at different ages, because the distinction genuinely matters.
First, the basics: what squint actually is
Squint — or strabismus, to use the clinical term — is a misalignment of the eyes where both eyes are not pointing at the same object at the same time. One eye looks at what you are focusing on, and the other goes its own way: inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia). It can be constant or intermittent, present in one eye or alternating between both.
In population-based studies, the prevalence of manifest strabismus in children is estimated at approximately 3–4%, making it one of the leading reasons children are referred to a paediatric ophthalmologist.1 But that figure lumps together very different presentations occurring at very different stages of visual development.
1 Mohney BG, et al. StatPearls. “Strabismus.” NCBI Bookshelf, updated March 2026. ncbi.nlm.nih.gov/books/NBK560782
Squint in newborns: often normal, sometimes not
In the first few weeks of life, a baby’s visual system is still very much under development. The brain has not yet learned to coordinate both eyes together. It is completely normal for a newborn’s eyes to wander or appear slightly crossed from time to time. Most paediatric ophthalmologists — and the American Academy of Ophthalmology — note that intermittent horizontal misalignment in a newborn is expected behaviour and not a cause for alarm.
By around 4–6 months of age, the eyes should be straightening out consistently. If they are not — if one or both eyes are still wandering, even occasionally — that warrants proper evaluation.
When does it become a concern in infants?
Any baby who continues to show signs of strabismus beyond 3 months of age should be referred to a specialist for further evaluation. Constant large-angle esotropia (eyes turned significantly inward) is unlikely to resolve on its own after 2–4 months of age.
Infantile esotropia: the form specific to early infancy
When a constant squint is present before the age of six months, we call it infantile esotropia — the most recognisable early-onset form. This typically presents as a large inward turn, often quite noticeable. The birth prevalence has been reported to range from 1 in 403 to as high as 1 in 50 newborns, depending on the population studied.
What makes infantile esotropia distinct is that it is not caused by a refractive error. The underlying cause is not fully understood, though genetics clearly plays a role. Premature birth and low birth weight are also known risk factors.
Squint in older children: a different set of causes
When a child develops a squint after infancy — say, between ages 1 and 5 — the picture is often quite different. The most common culprit in this age group is accommodative esotropia: a squint driven by the eye’s attempt to focus on near objects, often because the child is significantly long-sighted (hyperopic). A long-sighted child has to exert extra focusing effort to see clearly. That focusing effort is neurologically linked to the convergence of the eyes — the natural tendency for the eyes to turn inward when looking at something close. Acquired esotropia is actually more common than infantile esotropia, and typically presents between the ages of 1 and 4 years.*
*American Academy of Ophthalmology. “Esotropia and Exotropia Preferred Practice Pattern.” AAO Journal, 2022. aaojournal.org
Squint in newborns / infants
- Often intermittent and self-resolving before 4–6 months
- Constant squint after 3 months = refer to specialist
- Not typically caused by refractive error
- Genetics and prematurity are key risk factors
- Usually requires surgical correction
- No amblyopia or double vision symptoms reported (pre-verbal)
Squint in older children (1–7 yrs)
- Often linked to significant long-sightedness
- May start intermittently and become constant
- Glasses may fully correct accommodative cases
- Older children may report double vision or head tilting
- Risk of amblyopia (lazy eye) in the deviating eye
- Does not resolve on its own without treatment
A newborn’s visual system is at its most vulnerable — and most treatable — point. A squint in an infant that goes uncorrected can have a greater impact on long-term binocular vision development than one that develops at age 5, simply because of how much visual learning still has to happen. Conversely, a 5-year-old still has time on their side if the squint is caught and treated before school age. In all cases, the longer a squint goes untreated during the critical window of visual development, the greater the risk to long-term vision.
If something looks off with your child’s eyes, trust that instinct and get it checked. It rarely costs anything to look at, and it sometimes costs everything not to.
Have questions about your child’s eyes?
Our paediatric ophthalmology team at Sanjeevan is here to help — from routine squint assessments to complex cases requiring surgical management.
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