Strabismus
Strabismus is a vision condition characterized by an eye misalignment, where the eyes do not point in the same direction. One eye may look straight ahead while the other eye may turn inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia). This misalignment can be constant or intermittent and can affect one or both eyes.
Strabismus can lead to double vision because the brain receives conflicting visual information from the two eyes. In response, the brain may suppress or ignore the input from one eye, which can lead to a condition called amblyopia in the suppressed eye. Amblyopia can result in reduced vision in the affected eye if left untreated.
Strabismus can have various causes, including problems with the eye muscles, nerve issues, or a family history of the condition. It can manifest in children as early as infancy or develop in adulthood. It is essential to diagnose and treat strabismus, especially in children, because early intervention can help prevent amblyopia and improve eye alignment.
Treatment for strabismus may involve:
- Eyeglasses: In some cases, prescription glasses can help correct the alignment of the eyes.
- Eye patches or atropine drops: These can be used to encourage the weaker eye to work and develop stronger vision, particularly if amblyopia has developed.
- Vision therapy: This involves a series of eye exercises and activities to improve eye coordination and strengthen the eye muscles.
- Surgery: In some cases, surgical correction of the eye muscles may be necessary to realign the eyes. This is often considered when other treatments have not been successful or when there is a significant misalignment.
The treatment approach for strabismus depends on the individual's age, the severity of the condition, and the underlying cause. Should you or family member develop strabismus, urgent investigation by the team at Rose Optometry will help determine the most appropriate treatment plan.
Optometrists for strabismus at Rose Optometry
You will be seen by one of seven therapeutically qualified optometrists — all University of Auckland graduates, all able to prescribe eye medication where it is needed, and all of whom examine patients from six weeks of age.
- Jagrut Lallu — Partner Optometrist · BOptom (Hons), MSc Specialty Lenses (Hons), FIAOMC. Assesses eye turns and binocular vision in children and adults. Special interests: children's vision, myopia management, orthokeratology, keratoconus and scleral lenses, dry eye.
- Jacqueline Rowe — Partner Optometrist · BSc, BOptom. Assesses eye turns and binocular vision in children and adults. Special interests: dry eye and meibomian gland dysfunction, orthokeratology, keratoconus, children's vision.
- Emilie Lawson — BOptom (Hons) · Accredited Glaucoma Prescriber · ACO Certificate in Advanced Contact Lenses. Assesses eye turns and binocular vision in children and adults. Special interests: children's vision, myopia management, orthokeratology, glaucoma, keratoconus, dry eye.
- Jason Shen — BOptom (Hons). Assesses eye turns and binocular vision in children and adults. Special interests: keratoconus and specialty contact lenses, children's vision.
- Jessica Wood — BOptom (Hons) · Clinical Research Optometrist, New Zealand Eye Research Centre. Assesses eye turns and binocular vision in children and adults. Special interests: orthokeratology, keratoconus, dry eye, children's vision, clinical research.
- Stella Wong — BOptom (Hons). Assesses eye turns and binocular vision in children and adults; strabismus is one of Stella's special interests. All special interests: myopia management, orthokeratology, keratoconus and specialty contact lenses, binocular vision, dry eye, children's vision.
- Anjali Hira — BOptom (Hons). Assesses eye turns and binocular vision in children and adults. Special interests: children's vision, orthokeratology, keratoconus, dry eye.
Common questions about strabismus (squint)
Is strabismus the same as a squint?
Yes — squint is the everyday word, strabismus the clinical one. Both describe eyes that are not aligned on the same point: one may turn in, out, up or down, constantly or only sometimes.
Is strabismus the same as a lazy eye?
No, though they travel together. Strabismus is a problem of eye alignment. Amblyopia is reduced vision in one eye. A squint can cause amblyopia, because the brain suppresses the turning eye to avoid double vision, and that suppression stops that eye developing. You can have either without the other.
What causes strabismus?
In children, an imbalance in the muscles or in the nerve signals controlling them, often with a family history. A common and very treatable version is accommodative esotropia, where significant long-sightedness makes the eye turn in whenever the child focuses — glasses alone can correct that one. Onset in an adult is different and needs prompt assessment, as it can follow a neurological or thyroid cause.
How is strabismus fixed?
It depends entirely on the cause. Glasses correct some squints outright. Where amblyopia has developed, that is treated alongside. Prisms can help with smaller or intermittent deviations, vision therapy can help with convergence problems, and surgery to adjust the eye muscles is used where the deviation is large or constant. The assessment determines which of these applies — there is no single answer.
Does strabismus go away on its own?
Intermittent squints in the first few months of life often settle as the visual system matures. A squint that is constant, that appears after about four months of age, or that persists beyond that should be examined rather than waited out — because the risk while waiting is amblyopia. A sudden new squint at any age, particularly with double vision, needs same-day attention.
Squint assessment in Hamilton
Book a new child or student examination or an existing child examination. A sudden new squint in an adult or child should be phoned through on 07 847 3195 rather than booked online.
Rose Optometry, 38 Lake Road, Frankton, Hamilton. 07 847 3195
Reviewed by Jagrut Lallu — BOptom (Hons), MSc Specialty Lenses (Hons), FIAOMC. Therapeutic Optometrist & Contact Lens Specialist, Partner, Rose Optometry. Last reviewed August 2026.
This page is general information, not individual clinical advice. Please book an examination so we can advise on your eyes.
Frequently asked questions
At Rose, a standard adult eye examination is $129. A new patient appointment takes 45 minutes, and imaging and a full pre-examination workup are included in that price rather than added afterwards. Children and school students are $79, tertiary students $99, and an acute appointment for a sudden problem — a red eye, a foreign body, a sudden change in vision — is $69. Where further testing is needed it is quoted before it is done: visual fields $69, macular OCT $69, full OCT $194, anterior segment OCT $39, corneal topography $59, optical biometry $49, cycloplegic refraction $59. Specialist appointments are priced separately. A keratoconus consultation is $139 for 30 minutes or $169 for 45. An ortho-k consultation is $129. A full dry eye evaluation, which produces a written treatment plan, is $247 — it assumes a current full eye examination, either with us ($129) or a full examination record from another practice within the last six months. Fees elsewhere in New Zealand vary widely, and a lower advertised price usually means a shorter appointment with imaging charged as an extra or not offered at all. It is worth comparing what is included rather than the headline number. Ring us on 07 847 3195 if you want the fee for your situation confirmed before you book.
No practice can honestly claim that, and you should be wary of any that does — "best" depends entirely on what your eyes need. If your eyes are straightforward, several good practices in Hamilton will look after you well, and we would rather say that than pretend otherwise. What separates practices is what they can measure, and what they can treat when things are not straightforward. Rose was built around the complicated end. The Rose K lens for keratoconus was designed in this practice, and lenses of that family are, on the manufacturer's figures, among the most widely prescribed in the world for the irregular cornea. We hold swept-source OCT, corneal tomography, epithelial thickness mapping, two independent optical biometers for monitoring a child's short-sightedness, and objective tear film assessment. For dry eye we hold intense regulated pulsed light, LipiFlow, Blephasteam, Tixel and Rexon-Eye — to the best of our knowledge no other practice in New Zealand has all of these under one roof. A better question than "who is best" is "who is set up for what I have". Ask any practice you are considering how long the appointment is, what they can measure, and whether imaging is included or extra. Those answers will tell you more than a ranking would.
Not usually as a full examination, but there are genuinely free and subsidised pathways worth knowing about. Pre-school children are screened free through the B4 School Check, and there is vision screening in schools. Both are screenings rather than eye examinations — they are designed to catch obvious reduced vision and they miss a great deal, including focusing problems and early short-sightedness. A child who passes a screening can still need glasses. Children under 16 whose family holds a Community Services Card, or who hold a current High Use Health Card, may be eligible for the government spectacle subsidy towards an examination and glasses. MSD criteria apply, and we accept MSD and WINZ payment cards. Southern Cross members can use their optical benefits with us, and we offer Afterpay, Genoapay, QCard and GoCardless. We also run two free 15-minute chats. The myopia chat is for parents of a short-sighted child who want the options explained and want help deciding what is actually right for their family, with our experience behind that decision rather than a brochure. The ortho-k chat is for anyone considering overnight lenses who wants to understand what is involved before committing. Neither is an eye examination, but both are a proper conversation with someone who does this work. If cost is the reason you have been putting off having your eyes checked, ring us on 07 847 3195 and say so. We would rather find a way than have you not come.
While payment is generally required on the day of appointment, we do offer a number of payment options including Afterpay, Genoapay, QCard, and GoCardless.
No. We are closed on public holidays and long weekends as we believe our staff should have the chance to enjoy this time with friends and family.
If your eyes are straightforward, almost any good optometrist can look after you well, and we would rather say that than pretend otherwise. Come to us when something is not straightforward: a prescription that will not settle, a cornea that has changed shape, a child whose short-sightedness is moving faster than it should, an eye surface that has stopped being comfortable, or a diagnosis you have been given but do not understand. Those problems are decided by measurement, and measuring them properly needs instruments most practices do not have.
Yes, and you do not need to justify it. A second opinion is not a criticism of whoever saw you first — very often they were right, and what you actually needed was the finding explained and the numbers put in front of you. What we can add is measurement. We can image the layers of your cornea and retina, map the epithelium, quantify how far your cornea sits from normal, measure the length of your eye and check your tear film objectively. That turns “something is not right” into a number, and a number either explains the problem or rules it out. Bring any previous scans, prescriptions and letters. Comparison against your own past results is often the most valuable thing in the room.
Usually. Complex is what this practice was built around — keratoconus, corneal grafts, irregular corneas after surgery or injury, severe dry eye, high prescriptions, and eyes that have been told they are not fittable with contact lenses. The Rose K lens for keratoconus was designed in this practice, and lenses of that family are, on the manufacturer's figures, among the most widely prescribed in the world for the irregular cornea. If we cannot help, we will tell you at the first appointment and tell you who can, rather than taking you through a course of treatment that was never going to work.
Waiting is the one thing that cannot be undone. Short-sightedness is axial — the eye is physically growing too long — and that length does not come back. What treatment does is slow the rate of growth, so the earlier it starts the more length is saved. We measure axial length directly on two independent biometers and plot it against normal growth curves, which means we can see a child drifting off their expected curve before the prescription changes. There is a free 15-minute myopia chat if you want to understand the options before committing to anything. It is worth being precise about what we are all trying to achieve. Myopia control does not stop a child's eyes changing and no practice should tell a parent it will. What it does, reliably and across many published trials, is slow the rate at which the eye lengthens — and because the risk of retinal detachment, myopic maculopathy and glaucoma in later life rises with every extra millimetre, slowing that growth is how a child is kept out of the range where sight is genuinely at risk. After seventeen years of focusing on this, we are now seeing children on customised plans whose axial length is not progressing at all over a monitoring period, and in some cases measurements that come back slightly shorter than the ones before them. That is our own clinical observation in our own patients rather than a trial result, and it has to be read carefully, because the choroid thickens when treatment is working and part of an apparent reduction can be that thickening rather than the eye itself shortening. That is precisely why we measure both. We are not yet able to tell a parent that we can stop myopia in its tracks, and we will not say it until we can.
Two things: we measure it before treating it, and we hold every current treatment technology in one building. Most dry eye is treated on the basis of symptoms, which is why drops so often fail. A tear film can be failing because the oil layer is blocked, because the water layer is short, because the surface is inflamed, or because the lids are the problem, and those need different treatments. We assess the tear film objectively with TearCheck — tear film stability, the oil layer, lid and gland imaging, and an inflammation measure — and measure tear osmolarity, the saltiness of the tears, which is the closest thing to a laboratory number for dry eye. Then we treat the cause. Rose holds intense regulated pulsed light for inflammation and gland function, LipiFlow thermal pulsation to clear blocked meibomian glands from the inner lid surface, Blephasteam controlled-humidity warming, Tixel thermomechanical treatment for the lids, and Rexon-Eye quantum molecular resonance for the more severe and treatment-resistant cases. At the time of writing, and to the best of our knowledge, no other optometrist or ophthalmologist in New Zealand has all of these available under one roof. We say that as a statement of fact rather than a boast, and we would be glad for it to stop being true. Dry eye is one of the most common and most under-treated conditions we see, and there are far more people living with it than one practice can look after. Any practice wanting to build this kind of service has our encouragement and our help — please contact us for co-management, and send us the cases you are not yet set up for. Why holding all of them matters is simple. A practice with one dry eye machine will offer you that machine. Holding all of them means the assessment decides the treatment, rather than the equipment deciding it — and when the first approach does not work, the next one is in the next room rather than in another city.
Yes — from around six weeks of age. Babies and toddlers are tested with Cardiff acuity cards and retinoscopy, neither of which needs the child to read a letter, name a picture or say a word. Most of the findings that matter in a young child cause no symptoms and are invisible to a parent, which is exactly why they need looking for.
In NZ an optometrist can calculate the prescription for glasses, fit contact lenses, diagnose and treat eye conditions and infections with medication. They can also manage ocular injuries including removing foreign objects. If surgery or specialist treatment is required they can refer to an ophthalmologist (eye surgeon), hospital, or other health care specialist. NZ-trained optometrists must complete a 5-year degree at the University of Auckland before becoming registered.
A dispensing optician has formal training in optical dispensing. They are qualified to help a client choose frames, read a prescription, discuss lens options, take measurements, order and fit glasses.
An ophthalmologist is a medical doctor who has specialised in the treatment of serious eye disease and ocular surgery such as cataract removal. They do not typically prescribe glasses or contact lenses.
Not always, and the difference is usually time and instruments rather than the optometrist. A low advertised fee generally buys a shorter appointment aimed at producing a spectacle prescription. That is a legitimate service and for many people it is enough. What it often does not include is retinal imaging, OCT scanning of the optic nerve and macula, measurement of eye length, or objective assessment of the tear film — the tests that find glaucoma before you notice it, detect macular change early, monitor a child's short-sightedness properly, or explain why your eyes feel gritty. At Rose a new patient appointment is 45 minutes, and imaging and the full pre-examination workup sit inside the $129 rather than on top of it. We are not the cheapest and do not try to be. Whichever practice you choose, three questions are worth asking: how long is the appointment, is imaging included or charged separately, and what happens to the images afterwards. A scan that is taken and kept becomes the baseline every future scan is compared against, and that comparison is frequently worth more than any single result.
Start with an optometrist in almost every case. An optometrist is your first point of contact for eye health and vision — examining the eyes, prescribing glasses and contact lenses, diagnosing eye disease, and in New Zealand treating many conditions with prescription medicines. An ophthalmologist is a medical doctor and eye surgeon who treats serious disease and performs surgery such as cataract removal, and who does not usually prescribe glasses or contact lenses. Neither is better than the other; they do different jobs. Most eye problems are diagnosed and managed by an optometrist, and where surgery or specialist medical treatment is needed we refer you promptly and stay involved in your care. The exception is anything sudden and severe: sudden loss of vision, a curtain across your vision, severe eye pain with a red eye, or a shower of new floaters and flashes. Phone us on 07 847 3195 rather than booking online — a person, not a calendar, decides how quickly you are seen — or go to hospital.
We are at 38 Lake Road in Frankton, with parking on site, a few minutes from the city centre and straightforward to reach from the western side of Hamilton. Our patients come from right across the city — Frankton, Dinsdale, Nawton, Te Rapa, Glenview, Hamilton East, Hillcrest, Chartwell, Rototuna and the central city — and from across the wider Waikato, including Cambridge, Te Awamutu, Morrinsville, Matamata, Huntly, Ngaruawahia, Otorohanga and Raglan. Because much of what we do is specialist work, a good number travel considerably further. We regularly see patients from Auckland, Tauranga, Rotorua, Taupo, Taranaki and the lower North Island for keratoconus, scleral and custom contact lens fitting, and complex dry eye — and we see patients from overseas who combine treatment with a trip. If you are travelling a distance, tell us when you book and we will group your appointments so the journey is worth making.
Forty-five minutes for a new patient, and the appointment is built so the measuring is done before you sit down with the optometrist. A full pre-examination workup and imaging are included in the fee rather than charged on top: assessment of your vision and prescription, examination of the front and back of the eye, eye pressure, and retinal imaging that becomes your permanent baseline. You will leave knowing what we found, what it means, and what — if anything — needs doing. If the honest answer is that nothing needs doing, that is what you will hear. If something needs watching or treating, you get a clear plan and a review date. Where a specific problem needs a specific test — visual fields, OCT, corneal topography, eye length measurement — those are quoted to you before they are done, never added afterwards without your agreement. Existing patients returning for a routine examination are booked for 30 minutes. Please arrive ten minutes early, and bring your current glasses or contact lenses, any recent prescription or referral letter, and a note of the medications you take, because some affect the eyes.
Yes. We keep acute appointments for sudden problems — a red or painful eye, something in the eye, a sudden change in vision, new flashes or floaters — and we see you the same day wherever we can. An acute appointment is $69. Phone first, on 07 847 3195, rather than booking online. A two-minute call establishes whether you need us or the hospital, and a person, not a calendar, decides how quickly you are seen. Any Hamilton optometrist can be phoned for a same-day problem. If we cannot fit you in, we will tell you straight away so you can try the next nearest practice rather than wait. Some things should not wait for an appointment at all. For a chemical splash, rinse the eye with clean water straight away and keep rinsing, then go to the hospital emergency department. For sudden loss of vision, a curtain or shadow across your vision, a penetrating injury, or severe eye pain with a red eye, phone us immediately during opening hours; outside our hours, go to the Waikato Hospital emergency department or call Healthline on 0800 611 116 for advice. You do not need to be an existing patient, and you do not need a referral.
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