A baby with a crooked neck is also known as a squint. Some children do have a crooked head caused by an eye abnormality. For children who have no significant abnormalities on examination of the neck muscles and see with a crooked head, ophthalmic strabismus should be considered. Ocular strabismus is most often caused by congenital paralysis of the nerves that govern the extraocular muscles, most commonly the superior oblique muscle of one or both eyes. Children use head tilting to reduce the discomfort caused by strabismus. However, prolonged head tilting can have many negative consequences for the child. First, facial development is asymmetrical; secondly, it has an effect on the bones of the neck, causing cervical scoliosis; and it may also affect the development of the lower jaw. Therefore, the skewed neck caused by congenital paralytic strabismus should be treated with surgery early.