History

When faced with a case of suspected squint, certain aspects of the history can be helpful in assisting with the diagnosis. It is often useful to ask who first noticed the squint. Sometimes, a mother has been made anxious by a well-wishing neighbour or relative, and in these cases, there might be no true squint but merely the appearance of one. The mother herself is usually the best witness. Unfortunately, some children have a facial configuration that makes the eyes look as though they are deviating when they are not and it is essential that the student or general practitioner should be able to make this distinction in order to avoid sending unnecessary referrals to the local eye unit (Figure 14.2). Childhood squints often show a dominant pattern of inheritance and the family history provides a useful diagnostic indicator. From the point of view of prognosis,it is useful to find out whether the squint is constant or intermittent and also the age of onset. A full ophthalmic history must be taken, which should include the birth history and any illness that might have caused or initiated the problem.

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