What is strabismus?

June 8, 2017

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Strabismus is a condition when a person’s eyes don’t line up, or when one or both eyes wander. The eyes may turn inward (esotropia), outward (exotropia), up (hypertropia) or down (hypotropia).  Normally, the muscles attached to the eye work together to move both eyes at the same time. Strabismus is when the eye muscles do not work properly to control eye movement. Strabismus can be noticeable all the time, but sometimes is only noticeable when a child’s eyes are fixating on something very closely or when they are tired.

How is vision affected in kids with strabismus?

When a child’s eyes don’t line up together their brain ignores images from the weaker eye causing the straight, or straighter, eye to become the dominant eye. The vision in the dominant eye remains normal because the connection of the eye and brain are working correctly. The weaker eye will not focus properly because its connection with the brain is not functioning correctly. The vision in the weaker eye can become permanently blurry and the child can lose depth perception.

Thus, in some children, if strabismus is not treated, permanent vision loss can occur. The good news is, if it’s found and treated early, it usually can be corrected and children typically do not suffer permanent vision loss. The earlier strabismus is found and treated, the greater the chances are for the child to develop good depth perception, good vision and straight eyes.

Signs your child may have strabismus

The most common signs of strabismus are eyes that don’t look in the same direction at the same time, eyes that don’t move together, squinting or closing one eye in bright sunlight and tilting and turning the head to look at an object.

Most kids with strabismus don’t complain of eye or vision problems, though, some kids might complain of double vision or having trouble seeing in general. Typically, a parent or someone close to the child like a family member, teacher or health care provider will notice the child’s eyes are not straight.

It’s typical and normal for a newborn’s eyes to cross or wander every now and then, but by the time a baby is 4 to 6 months old, the eyes should appear to be straight. Typically, children with strabismus are diagnosed between the ages of 1 and 4 years of age, but the condition can occur at any age.

Treatment for strabismus

Treatments for strabismus include eyeglasses, eye patching, eye drops eye exercises and eye muscle surgery.

Sometimes, wearing eyeglasses is all it will take to straighten out a child’s eyes. An eye patch forces the weaker eye to do the seeing causing the vision in the weaker eye to become stronger over time. If a child refuses an eye patch, eye drops that temporarily blur vision, called atropine drops, may be used. Just as the eye patch forces the weak eye to do the work, so do the eye drops. If eye glasses, eye patching and/or eye drops do not correct a child’s strabismus, your eye specialist may recommend eye muscle surgery. Eye muscle surgery for strabismus includes loosening or tightening of the muscle that causes the eye to wander.

Learn more about ophthalmology at Texas Children's.

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