What is strabismus?

Strabismus is a condition in which both eyes don't look at the same thing at the same time. One eye may look straight ahead while the other eye looks in another direction. It is sometimes called "cross-eye" or "walleye."

It occurs when the eye muscles don't work together to move both eyes in the same direction at the same time. This sends two different images to the brain. In a young child with strabismus, the visual system in the brain may not develop as it should. The brain may ignore the images from the weaker eye and use only the images from the stronger eye. This can lead to poor vision in the weaker eye.

The most common signs of strabismus are:

• Eyes that don't look in the same direction at the same time. (If your child's eyes are only slightly misaligned, you may not notice.)
• Eyes that don't move together.
• Squinting or closing one eye in bright sunlight.
• Tilting or turning the head to look at an object.
• Bumping into things. (Strabismus limits depth perception.)

An older child may also complain about blurred vision, tired eyes, sensitivity to light, or double vision.

Symptoms may come and go. They may get worse when your child is tired or sick.

A newborn's eyes may be misaligned at first. But the eyes should become aligned by 3 to 4 months of age. In some cases, the eyes may simply seem to be misaligned because the child has a wide bridge of the nose that creates the appearance of crossed eyes.

A doctor can often tell that a child has strabismus just by looking at the child's eyes. It may be obvious that the eyes don't look in the same direction at the same time.

The doctor may have the child look at an object while covering and then uncovering each eye. This allows the doctor to see which eye turns, how much it turns, and under what circumstances the abnormal turn occurs. These tests will also help the doctor find out if the child has amblyopia (lazy eye), which sometimes occurs with strabismus.

Experts recommend that children have regular eye exams. Vision tests may also be done to look for strabismus. If you have concerns about your child's eyes or vision, call your child's doctor, or take your child to an eye doctor.

The most common treatments are:

• Glasses. They can sometimes correct mild strabismus. Some glasses have prisms in them that may help with some symptoms.
• A temporary eye patch that you wear over the stronger eye. You may wear one all the time. Or you may wear it only during certain times, such as when you are reading. Some patches cover the whole eye. Others are put on your glasses and cover only part of an eye.
• Surgery on the eye muscles to try to align the eyes better. It may take more than one surgery. You may still need to wear glasses.
• A shot of medicine into the eye muscles.
• Eye exercises.

You may need more than one treatment. Some people don't need treatment.

• Follow directions for wearing an eye patch or glasses or using eyedrops. Your doctor will tell you how many hours a day your child should wear the patch or glasses or how often to use eyedrops.
• Give your child lots of love and support during treatment. Your child may be teased at school for wearing a patch or glasses. Remind your child how important the patch or glasses are to help your child's vision.
• Explain the treatment to your child's teachers. Then they can help support your child.