squint in a child - NICE guidance - suspected neurological conditions - recognition and referral

Last edited 05/2019 and last reviewed 11/2020

Squint

Summary points from NICE relating to squint in children are:

New-onset squint with loss of red reflex

  • refer immediately children with new-onset squint that occurs together with loss of red reflex in one or both eyes to ophthalmology services

New-onset squint with ataxia, vomiting or headache

  • refer immediately children with new-onset squint that occurs together with ataxia, vomiting or headache to acute paediatric services

Paralytic squint

  • refer urgently children with paralytic squint for neurological assessment, even in the absence of other signs and symptoms of raised intracranial pressure

Non-paralytic squint

  • refer children with non-paralytic squint to ophthalmology services

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