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Strabismus (Crossed Eyes)

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About Strabismus (Crossed Eye/Eye Turn)

Strabismus is when your two eyes are unable to maintain proper alignment. The eyes don’t work together as a team, sending your brain “mixed messages”; one eye focuses on what you are looking at, with the other being misaligned. Ultimately, your brain will opt to favor the more dominant eye.

There are four main types of strabismus:

  • Esotropia – commonly called “crossed eyes”, this occurs when your other eye is misaligned inward
  • Exotropia – this occurs when your other eye is misaligned outward
  • Hypertropia – this occurs when your other eye is misaligned upward
  • Hypotropia – this occurs when your other eye is misaligned downward

Strabismus can have a profound impact on a child’s self esteem and ability to flourish in school. If strabismus is left untreated, the weaker eye will generally develop amblyopia1 (lazy eye).

What Causes Strabismus?

Strabismus generally develops when you are a child. It occurs when there are problems with your ability to control the six extraocular muscles that control eye positioning and movement. This may be related to the nervous system of the eye or due to the extraocular muscles themselves.

Strabismus may be persistent as well as intermittent (meaning that it cuts in and out at seemingly random intervals).

Signs & Symptoms of Strabismus

Parents tend to identify strabismus in their child visually, as one eye is often visibly out of alignment. When the misalignment of the eyes is fairly obvious, this is called “large-angle strabismus” (as the angle between the line of sight of the correct and misaligned eye is large). More subtle cases of strabismus are called “small-angle strabismus”.

Most kids with large-angle strabismus don’t experience symptoms of fatigue, strain, or headaches because the causes of those symptoms – the brain/body trying to realign or focus the eye, for example – doesn’t actually exist. In large-angle strabismus, there is no attempt by the brain/body to realign the eye.

Symptoms of small-angle strabismus include:

  • Headaches
  • Eye fatigue/strain
  • Difficulty reading
  • Unstable vision

Treating Strabismus

In cases of intermittent and small-angle strabismus, non-surgical treatment via vision therapy is a good option. Vision therapy centers around teaching the brain to better control the misaligned eye. This is done via eye strengthening exercises and the use of an eye patch.

For cases where vision therapy is not an option, surgical treatments are quite effective. In some cases, more than one surgery may be required to properly align the eye.

It is important that strabismus is treated early, as the risk of developing amblyopia is very real.