STRABISMUS

(Crossed Eyes)

 Basic information

description

• With strabismus, the eyes do not line up in the same direction when focusing. One or both eyes may turn inward, outward, upward, or downward. Normally, eye movements are controlled by brain signals to six muscles around each eye. Loss of this coordinated movement results in an unequal focusing ability. Strabismus (also called crossed eyes) usually affects children, but can develop in adults.
  • In young children, when the two eyes fail to focus on the same image, the brain can ignore the input from one eye. If this continues, that ignored eye will never see well (called amblyopia or lazy eye). Children do not outgrow strabismus.
  • Adults who develop strabismus often have double vision. This happens because the brain has been trained to receive images from both eyes and will not ignore the image from the affected eye.

FREQUENT SIGNS & SYMPTOMS

• Eyes of infants may appear to be crossed, though they are not (this is called pseudostrabismus).
• An eye that is not straight.
• Eye movement that is not coordinated. This may be constant, or it may come and go.
• Child may look at you with one eye closed, squint, or with the head turned to one side.
• Adults have double vision, eyestrain, headaches, or abnormal head position (from trying to see properly).

causes

For most children, the cause of strabismus is unknown. It is often present at, or shortly after, birth (congenital strabismus). In adults, there are known risk factors.

risk increases with

• Children:
  • Family history of strabismus.
  • Down syndrome, cerebral palsy, or hydrocephalus.
  • Brain tumor, prematurity, cataract, or eye injury.
• Adults:
  • Eye disease, eye injury, stroke, head injury, certain surgeries, thyroid disease, myasthenia gravis, diabetes, or having had childhood strabismus.

PREVENTIVE MEASURES

None specific. Ask your child's health care provider about routine visual screenings to detect any problems.

expected outcomes

• With early diagnosis and treatment for children, the outcome is usually excellent.
• Strabismus symptoms in adults can be improved with treatment.

possible complications

• Without treatment in children, vision weakness or vision loss in one eye may become permanent. In adults, the symptoms will continue or worsen.
• In adults and children, surgery complications may occur or symptoms may recur after treatment.

 diagnosis & treatment

general measures

• Your health care provider will do an exam of the eyes. Medical tests may include a visual acuity test, a retina exam, and others.
• Treatment depends on the patient's age, the cause of the problem, and the type and degree of the eye turn.
• The goals of treatment are to straighten the eyes and preserve binocular (both eyes) vision.
• Treatments may include:
  • Glasses to correct vision in the weaker eye (child).
  • Wearing a patch over the good eye or using eye drops to temporarily blur the vision of the good eye will force a child to use the weaker eye.
  • Eye exercises to strengthen eye muscles.
  • Surgery to tighten, loosen, or reinforce eye muscles is often recommended to realign the eyes.
  • Eyeglasses with prisms to correct mild double vision in adult strabismus.
• To learn more: American Academy of Ophthalmology, PO Box 429098, San Francisco, CA 94142; (877) 887-6327; website: www.eyecareamerica.com.

medications

Botulinum toxin (Botox) injection may be prescribed to relax an overactive eye muscle. It is injected into an eye turning muscle, outside the eye, with a special needle.

activity

No limits.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of strabismus.
• Any new symptoms develop during or following treatment.

Special Notes: