Strabismus

By Judith Lee and Gretchyn Bailey; reviewed by Vance Thompson, MD

Strabismus is a condition where your eyes don't look toward the same object together.

One eye moves normally, while the other points in (esotropia or "crossed eyes"), out (exotropia), up (hypertropia) or down (hypotropia).

Strabismus can lead to amblyopia. Strabismus is the physical disorder, and amblyopia is the visual consequence.

Strabismus Symptoms and Signs

Newborns often have crossed eyes due to a lack of developed vision, but this disappears as the infant grows. True strabismus does not disappear as the child grows.

Visit your eye care practitioner if you're unsure if your child has true strabismus. The earlier the diagnosis and treatment following a child's eye exam, the better the visual results. Without treatment, your child may develop blurry or double vision.

What Causes Strabismus?

Strabismus may be caused by unequal pulling of muscles on one side of the eye or a paralysis of the ocular muscles.

Occasionally, when a farsighted child tries to focus to compensate for the farsightedness, he or she will develop accommodative strabismus. This condition usually appears before two years of age and can occur as late as six.

Strabismus Treatment

Treatment for strabismus is similar to amblyopia treatment: vision therapy including patching or visual exercises, glasses with the correct prescription or bifocal or prism correction to aid in proper focusing, eyedrops to help focus or surgery. Surgery will correct the misaligned eyes but cannot resolve amblyopia caused by strabismus.

Strabismus is a condition where your eyes don't look toward the same object together.

Some eye surgeons disagree about the appropriate age for an infant or young child to undergo surgery to correct misaligned eyes. But new evidence suggests that it may be important to correct strabismus as soon as possible so that motor skills such as crawling and grasping can develop appropriately.

In early 2008, researchers at the Retina Foundation of Southwest Texas reported an association between accelerated development of motor skills after infants with strabismus underwent corrective surgery.

Before scheduling a child for surgery, some eye care practitioners inject the ocular muscles with Botox (botulinum), which temporarily relaxes the muscles. In some cases, strabismus is permanently corrected in this way.

[Page updated January 2009]