This baby has a squint

It is important to find out whether the parents have noticed the squint. The risk of amblyopia is high if the squint is long-standing and constant in nature.

Examine the corneal reflexes to see if the baby does indeed have a squint. Ignore the amount of sclera showing – concentrate on the light reflex on the cornea. Prominent folds of skin at the inner canthus can fool the examiner into thinking that the baby has a convergent squint. It is probably best to refer all such babies, as only an assessment by an orthoptist will determine for certain that ocular alignment is normal.

Such babies should be referred soon via letter, either to the paediatric ophthalmologist or direct to the orthoptic services, if this route of referral is available to you.