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Adult & Child Strabismus



Strabismus, also known as crossed eyes. This is a visual problem in which a misalignment of the eyes prohibits both eyes from focusing on the same point at the same time. One eye may look straight ahead, while the other eye turns inward, outward, upward, or downward. One of the eyes often has a shortened or elongated muscle that controls eye movement. It is estimated that up to 5 percent of all children have some type or degree of strabismus.

Strabismus, in which the misaligned eye turns in or out, is divided into two categories:

  • esotropia ("crossed" eye) means an eye turns in towards the nose, and
  • exotropia ("wandering" eye) means an eye turns out away from the nose.

In addition, the eye turn may be constant or happen only at times, such as when the child is tired; it may be the same eye which always turns, or the left and right eyes may turn alternately. The child's eye may turn only when he is looking at objects close up, or it may turn when looking both near and far. The degree of eye turn may be so great that it is readily noticeable, or slight enough that parents may fail to recognize there's a problem.

Due to the fact that the brain has not learned to align the eyes and use them together, each eye points independently of the other. This means that both eyes do not point at the same place at the same time. When each eye is looking at a different place, the brain receives two different "pictures." This would normally result in double vision but children's brains learn to protect themselves from seeing double by suppressing, or "turning off" the crossed eye. This occurs because of the misalignment of the two eyes in relation to one another. In an attempt to avoid double vision, the brain will eventually disregard the image of one eye (called suppression). This essentially means that children with a crossed or wandering eye only see out of one eye at a time.

What are the symptoms of strabismus?

It is normal for a newborn baby's eyes to move independently and at times, even cross. However, by three to four months old, an infant should be able to focus on objects and the eyes should be straight, with no turning. If you notice that your child's eyes are moving inward or outward, if he/she is not focusing on objects, and/or the eyes seem to be crossed, you should seek professional attention from a pediatric ophthalmologist. Thirty to fifty percent of children with strabismus develop secondary vision loss (amblyopia, also know as lazy eye). The onset of strabismus is most common in children younger than 6 years of age. The symptoms of strabismus may resemble other medical conditions. Always consult your child's physician for a diagnosis.

Strabismus Treatment

Strabismus treatment may include one, or more, of the following:

  • Eyeglasses
  • Eye drops
  • Surgery to straighten the eyes
  • Eye exercises
  • Eye patch over the strong eye (if amblyopia is present) to improve the weak eye

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