Very sudden squint in older child

[paintedpanda]

My DS (age 8) has all of a sudden got a turn in his right eye.

I have pictures from 11th Dec where there is no evidence of a turn at all. Just before Christmas, my DP noticed he was watching tv with one eye closed and DS said it was because he was getting double vision. When I looked at him straight on, I noticed his eye was turned inwards. When I covered his left eye, his right eye turned back to normal.

I have made an appointment for the opticians on Monday but I have been Googling (I know, I know, not the best idea!) and it says that sudden onset of a squint with double vision particularly in older children should go for urgent referral as it could be neurological. I am absolutely panicking now. Does anyone have any experience of anything like this??

For full disclosure, DSs dad was born with marked bilateral squints. Very obvious from a very young age which was corrected with surgery. Because of this, DS was under the care of the orthoptist and the ophthalmologist until he was 3yo when he was discharged as there was no evidence of a problem. However, during his first few appointments, they said he was more long sighted than was normal for a child of his age, but didn't recommend glasses as it would probably sort itself out. He had an eye test 2 years ago which did not flag up any vision problems.

Any chance of getting into an opticians today or tomorrow as an emergency?

No experience of squint, sorry op. But I got shot in the eye by a nerf gun and the emergency eye clinic was all over it with same day appointment availability (I presented through 111 and then a&e on their advice). I had changing symptoms over a few weeks and whenever I phoned up I was brought in next day to be reviewed. This all happened in September / October time (so coronavirus impact was happening).

If I were you I’d call 111 or GP (if you can get through) to go down the route of creating a referral back to your ophthalmologist as they will have your sons history.

Can the optician you’re seeing refer in to the nhs?

I had this happen as an adult. Not to alarm you op but I needed a couple of brain scans as the cause for me was neurological. I was lucky I think as it resolved itself, but I was advised that if it didn't then the first treatment would have been steroids

Monday will be fine to see the optician.

They'll also have a look at the optic nerve, which is a very good indicator of more serious issues.

They'll refer you on to the correct ophthalmology clinic, we'd always refer a sudden onset squint anyway. If necessary they can refer you as an emergency.
Going via the optician is sometimes easier/quicker than going via the GP, depending on the area and they may be able to do something to relieve the double vision.

Can I just check that the eye isn't red, painful or sensitive to light?

Thank you all.
No, not red, painful, or sensitive.

Good luck tomorrow OP.

Sorry - good luck Monday, d’oh!

Thank you. I didn't sleep well last night at all. I feel sick with worry and I feel ridiculous for that because he will probably be fine.

Squint onset at 8 is uncommon but it does happen, the optician will refer you to the local orthoptic and ophthalmology team. We do see a number of children each year with later onset squints and most of them do not have a serious underlying cause in a child who is otherwise well, but you are right that the risk is greater the older the child at onset of squint. Hope the appt goes well today

How did you get on today? I hope you have a referral?

They reluctantly referred, although it was a bit of a battle to get them to refer to my local hospital rather than theirs. But with all this lockdown stuff I don't even know whether we'll get seen soon

My dd had a sudden onset divergent squint aged 10.
She complained of double vision on and off, then it quickly became permanent.
She was given a patch while she waited for surgery. The surgery was successful for about 5 days, then unfortunately the double vision/squint returned.
She is now waiting for a second surgery but we’ve been told it’s very possible that it won’t work and it’s something we will have to adjust to. (Prisms dont work either)
I’m guessing the optician is happy with the optic nerve? I’d push and call ophthalmology to ask for a cancellation slot if one comes up.

Good luck

To be on the safe side I would take a look at the symptoms here: www.headsmart.org.uk/symptoms/signs-and-symptoms/
I hope you’re not waiting long for your appointment

I phoned the eye clinic and they said they were working as normal, so we are just waiting for our appointment letter now.
Thank you all for your help

If he's had surgery to correct squint did they mention that he may need further surgeries as he grows older?

Ds2 had surgery for a severe squint as a toddler and we were told that as he grew, it was entirely possible he would need surgery again as the squint would return eventually.

Hopefully it is just a growth spurt has caused the original correction to fail (if I remember, they shorten muscles in the eye) rather than anything serious.

@minisoksmakehardwork it's the dad that had the issue.

OP I'm glad you've been referred. Was the disc okay? If it was and there are no other symptoms on the link that @DailyCandy posted, I wouldn't worry too much. I still needs checking, but squints can suddenly decompensate - illness, doing more close work, growing......

He didn't check the optic nerve as far as I could tell. I took DD for her (routine) appointment yesterday at the same place but a different optician and they did all sorts of tests on her that the other optician didn't do on DS, including taking a picture of the back of her eye and explaining it to us.

I have just had a thought though. On the 4th December, DS hit his head at school and got it glued at A&E. Could this have contributed to his eye?! His cranial nerves were checked as standard when someone presents with a head injury, but could it have been delayed?

@minisoksmakehardwork it was DSs father who had surgery to correct his squint. I just added it because I know sometimes these things are familial. Thank you for your experience though, I didn't know a growth spurt could do that so I guess it could just be that he's growing.

"I have just had a thought though. On the 4th December, DS hit his head at school and got it glued at A&E. Could this have contributed to his eye?!"
Possibly OP. Mention it at your referral.
We can look at the optic nerve just by looking through the pupil with a light. It happens at every eye exam.

DS had his ophthalmology appointment today. The orthoptist was really helpful but when we saw the ophthalmologist, he had a quick look, prescribed glasses, then shooed us out of the door. I didn't have a chance to ask any questions. I left wondering where I even go to get the glasses!
I was wondering if anyone knew how quickly glasses can help him? They're just plain lenses, as far as I can tell. No prisms or anything special, no different from my own glasses (aside from DSs are for long sightedness and mine for short). So, will this help his double vision? Will it correct his squint?

Yes, should do when he puts them on - and that's clearly why the optometrist wasn't keen to refer. Just take the prescription to any optician - although most of them want you to call beforehand at the moment.
+ve prescriptions (for longsightedness) help squints that go inwards (esotropia) and
-ve prescriptions (for shortsightedness) help squints that go outwards (exotropia)

Hi. I was wondering how your DS is getting on? My DD then 8 got intermittent then permanent squint double vision last year. To cut a long story short they recommended Botox and not glasses 🤷‍♀️ I’ve not spoken to anyone else with this happening so interesting to hear