Strabismus

Overview

If you have strabismus, while one eye looks ahead, the other may turn inward, outward, down or up, giving the appearance of “crossed eyes” or a “wandering eye.”

Strabismus affects as many as four percent of children under age six. This condition can also develop in adults of any age or can continue from childhood.

Symptoms

In children and adults, the symptoms can be constant or can come and go, and they can shift between eyes.

Strabismus causes the eyes to pick up two different images. In children, the brain quickly learns to ignore one of the images. If this happens, vision in the eye that is being ignored can decline, causing amblyopia (lazy eye). Early treatment of strabismus is important because after a certain time period, this vision loss becomes permanent.

Adults experience strabismus differently because their brains cannot “turn off” an eye. The results can include double vision, eye fatigue and loss of depth perception. In children and adults, strabismus often affects self-confidence and impairs social interactions.

Causes

The cause of strabismus is usually unknown, but the condition can run in families. In adults, strabismus is sometimes related to other conditions, including Graves’ disease (hyperthyroidism), stroke and trauma.

Treatment

Strabismus is a highly treatable condition in children and adults. Treatment can help you or your child to have better eyesight and increased confidence.

Early treatment of strabismus is especially important in children. If strabismus is not corrected before about age eight or nine, the brain can learn to ignore the misaligned eye, causing permanent vision loss in that eye. Adults are not at risk of this problem, but may experience double vision. The best treatment depends on many factors, including the cause and severity of the strabismus.

Options include:

Non-surgical Methods

Certain types of strabismus respond to treatment with eyeglasses, prisms, Botox or vision exercises. These techniques generally work only if the strabismus is mild. However, glasses, prisms and eye exercises can also be helpful in fine-tuning results after surgery.

Surgery

Outpatient surgery to tighten or loosen some of the six muscles that surround the eye can correct strabismus. The adjustments are based on precise measurements of the strabismus. To reach the muscles, a small cut is made in the clear layer of tissue that covers the white part of the eye. Your skin is not cut. The position of the muscle attachments are moved or small sections of tissue are cut away to achieve the proper tension. At times, an adjustable suture is used to allow for small changes later.

Adults usually receive local anesthesia and can go home the day of surgery. Children require general anesthesia. Most people can return to normal activities within a few days.