"It will fix itself" and "laser can fix a squint": what the family says about crossed eyes
Grandparents, aunties and the internet all have a view on a baby's crossed eyes. Some of it is true for a few weeks, and some of it costs a child time. Here is each saying, and what the sources say.
- A baby's eyes may cross or wander in the first 2 to 3 months. Any crossing beyond 4 months, constant or on and off, should be checked, and constant crossing at any age should be seen.
- A flat nose bridge can make straight eyes look crossed. That is pseudostrabismus, and a child can outgrow it but not a true squint.
- A squint can cause a lazy eye, where the brain ignores the turned eye. The AAO says amblyopia is best treated before age 7 or 8, so waiting costs time.
- Laser eye surgery reshapes the cornea to correct focus. It is not a squint treatment listed by the NHS or AAPOS, and no laser is approved for LASIK under age 18.
- Glasses, patches and surgery do different jobs: glasses correct focus and sometimes alignment, a patch trains the weaker eye, and surgery changes where the eye points.
A squint that is still there after about 4 months of age does not fix itself, and it should be checked. Only some babies' eyes look crossed because of a flat nose bridge, and that look is not a true squint. Every family has a few sayings about crossed eyes, "it will fix itself" and "laser can fix it" among them. Each one is half true or not true at all, so here they are one at a time, with what is actually known.
Is it a real squint, or does my baby only look crossed?
Often the eyes are straight and the face is doing the trick. The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) defines pseudostrabismus as eyes that look as though they are not straight but actually are, caused by a flat nasal bridge and small folds of skin at the inner corners of the eyes. The American Academy of Ophthalmology (AAO) says that in children under one year old the eyes may look crossed when they really are not.
The look can fade as the face grows, and the treatment is none. But AAPOS adds that a baby with pseudostrabismus may get a true squint later, so one examination is worth having. A doctor tells the two apart with a light shone into both eyes and a cover test. I cannot do that from a photograph, and neither can anyone at the dinner table. The full explanation is in my baby looks cross-eyed in photos: when it is the nose bridge, not a squint.
Myth: "It will fix itself." Does a squint go away on its own?
In the first weeks it often does. After that, a true squint does not. The AAO puts it in one line: a child can outgrow pseudostrabismus, but not strabismus.
The timeline has a window. The AAO says babies' eyes often do not work together well for the first 2 months, so they may look crossed or wander, and that by 3 months the eyes should work together to focus and track. The NHS says squints that come and go in babies younger than 3 months are common and not usually a worry. AAPOS says a small, intermittent inward turn in a baby younger than about 4 to 5 months is common and generally goes away on its own, but that any crossing, constant or on and off, beyond 4 months should be checked, and that constant crossing at any age is worrying. The sources differ by a month or so, so treat it as a window and not a date.
The action: if the eyes still cross at 4 months, book a check. Do not wait for 6 months or a year, and do not let anyone say "wait and see" for you. Cross eyed baby: what is normal, and when to have it checked sets out month by month what is ordinary.
Myth: "It is only how the eye looks. The sight is fine." Can a squint harm vision?
Yes, it can. The AAO explains that if the eyes are not aligned, amblyopia can develop, which is when the misaligned eye has weaker vision. AAPOS describes the same thing: the brain may ignore the image from the misaligned eye to avoid double vision. The NHS calls it a lazy eye, where the brain starts to ignore signals from the affected eye, so the child does not develop normal eyesight.
The AAO says that for best results amblyopia should be treated before a child is 7 or 8 years old. So "it will fix itself" is not harmless. Every month of waiting uses up some of that time. A squint that is treated late is not hopeless, and what lazy eye treatment can still do when it is found late has the figures. Squint and lazy eye are two different things, and one can occur without the other.
Myth: "Laser can fix a squint." Can laser eye surgery straighten the eyes?
No. No source says laser straightens eyes, and the reason is in what laser does. The US Food and Drug Administration (FDA) describes LASIK as removing corneal tissue with a laser to reshape the cornea and change its focusing power, to correct short-sightedness, long-sightedness and astigmatism. A squint is not a focusing error. It is eyes pointing in different directions.
The lists of squint treatments agree. The NHS names glasses, eye exercises, surgery and injections into the eye muscles. AAPOS names glasses, exercises, prism and eye muscle surgery. Laser is on neither list. Separately, the FDA states that no lasers are approved for LASIK on anyone under 18, so a child could not have it in any case. Refractive surgery in children: the rare cases and why glasses usually win explains this.
The word "surgery" for a squint means something different: the doctor adjusts the small muscles on the outside of the eye. No laser is involved in the sources above. If an advertisement promises to straighten a child's eyes with laser, that is a reason to ask which treatment is actually meant.
Myth: "A patch or glasses will straighten the eyes." What do they actually do?
They do different jobs, and sometimes glasses do straighten the eyes. The AAO says eyeglasses can correct a squint when a vision problem such as short-sightedness is contributing, and the NHS says glasses can help if a squint is caused by a problem with the child's eyesight. AAPOS adds that some inward turns get better with glasses (it calls them accommodative) while others do not.
A patch is different. The AAO describes patching, or eye drops, as a way to strengthen the weaker eye in amblyopia: a patch over the stronger eye, or drops or a lens that blur it, which makes the child use the weaker one. Several months are usually needed. So a patch works on how well the eye sees, and glasses work on focus and sometimes on alignment. Neither is a promise to straighten a stubborn squint.
Is surgery "the last resort", and when is it considered?
Surgery is considered when other methods are not enough. The AAO says surgery may be necessary when other methods prove insufficient, and that after surgery most children get back to their daily routine in about 2 to 3 days. The NHS lists surgery alongside glasses and injections, as one of the options, not as a punishment.
It changes where the eye points. It does not treat lazy eye, which carries on separately. Our page on what happens on the day answers the question most parents are afraid to ask, whether the eye is taken out. It is not. If you want to know how long the wait is and what to ask, squint surgery in Malaysia has that.
What is "juling itik", and what do I tell Ah Ma?
"Juling itik" has no meaning in medicine, and no source fixes what the phrase means. Different families may use it for different looks, so I will not guess. Whatever your family means by it, the test is the same: are the eyes pointing the same way, and is each eye seeing?
Grandparents who say "it will fix itself" are repeating something that is true for the first few weeks, and for a flat nose bridge. They are not careless, and the sayings come from love. You can say: "You are right that it can settle in a young baby. If it is still there at 4 months, the doctor should look." For the other old sayings about children's eyes, children's eye myths and what Ah Ma got right about your child's eyes go through them kindly.
If the eye turns only now and then, the same rule holds, and the squint that comes and goes explains why. A turn that appears suddenly in a toddler is a different matter, set out in sudden squint in a toddler.
- An eye turns all the time, at any age.
- The eyes still cross, even now and then, after 4 months.
- An eye turns suddenly in a toddler or older child.
- A child sees double or tilts the head to look at things.
Common questions
Will my baby's squint go away by itself?
Why does my baby look cross-eyed in photos but not in real life?
Can laser fix a squint?
Can a squint make a child's eyesight worse?
Will glasses or a patch straighten my child's eyes?
When is squint surgery considered?
What does juling itik mean?
- American Academy of Ophthalmology · Strabismus in children · www.aao.org
- American Academy of Ophthalmology · Amblyopia (lazy eye) · www.aao.org
- American Academy of Ophthalmology · Baby's vision development in the first year · www.aao.org
- AAPOS · Pseudostrabismus · aapos.org
- AAPOS · Esotropia · aapos.org
- AAPOS · Strabismus · aapos.org
- NHS · Squint · www.nhs.uk
- FDA · What is LASIK? · www.fda.gov
- FDA · When is LASIK not for me? · www.fda.gov