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Strabismus

What is strabismus?

Strabismus is a misalignment of the eyes. The eyes (one or both) may turn inward, outward, up, or down. This condition is also called wandering eye or crossed eyes.

This is one of the most common eye problems in children.

What causes strabismus?

Experts aren’t sure what causes this issue. It may happen when the eye muscles don’t work together.

Who is at risk for strabismus?

The brain controls the eye muscles. Children with brain conditions are more likely to have strabismus. These conditions can include cerebral palsy or hydrocephalus.

This condition seems to run in families. Siblings and children of a person with strabismus may be more likely to develop the condition.  

What are the symptoms of strabismus?

Symptoms can occur a bit differently in each child. Strabismus often starts in children younger than 6 years of age.

It’s normal for a newborn's eyes to move independently. Sometimes they may even cross. By 3 to 4 months of age, your baby’s eyes should be straight, with no turning. Your child should also be able to focus on objects.

Call your child’s healthcare provider if your child's eyes move inward or outward or look crossed. You should also call your child’s healthcare provider if your child cannot focus his or her eyes. Children with strabismus may also develop secondary vision loss (amblyopia). This is also called a lazy eye.

The symptoms of this condition may look like symptoms of other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is strabismus diagnosed?

Your child’s healthcare provider will diagnose it during an eye exam. All children should have an eye exam by 3 years of age. But if your child has signs of strabismus or other eye issues, he or she may need an eye exam earlier.

Getting this condition diagnosed and treated early can help prevent vision problems.

How is strabismus treated?

Your child may need to see an eye doctor (ophthalmologist or optometrist) for treatment. Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Your child’s treatment may include:

  • Eyeglasses
  • Eye drops
  • Surgery to straighten the eyes
  • Eye exercises
  • Eye patch over the strong eye to improve the weak eye

What are the complications of strabismus?

Your child will not outgrow this condition. But early treatment can prevent other eye issues. These include vision problems, such as lazy eye, and even blindness.

Key points about strabismus

Strabismus is a misalignment of the eyes. The eyes (one or both) may turn inward, outward, up, or down.

  • This is one of the most common eye problems in children. It usually starts when your child is younger than 6 years of age.
  • Getting this condition diagnosed and treated early can help prevent vision problems.
  • Your child may need to see an eye doctor (ophthalmologist or optometrist) for treatment.
  • Glasses, eye drops, eye exercises, or surgery may be part of your child’s treatment plan.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Medical Reviewers:

  • Berry, Judith, PhD, APRN
  • Holloway, Beth, RN, M.Ed.