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Strabismus: Explanation and Treatment Options

By Corina Iatisin
Reviewed by Beck Jinette
Beck Jinette

Reviewed by

Beck Jinette
Beck has over 17 years of experience in eye care, holding her Certificate IV in Dispensing in Australia.
What is strabismus? Learn about its causes, symptoms (including when they appear) and treatments.

Have you ever wondered if there are glasses able to correct strabismus? Or if any other treatments can help? Find all the information you need about strabismus, what it is, why it occurs, and all the treatment options.

What is strabismus?

Strabismus (also sometimes known as crossed eyes) is a condition where one of the eyes is not aligned with the other – i.e.; it looks in a different direction from the other eye.  

Six muscles control the movement of the eyes. Under normal conditions, these muscles work together and point the eyes in the same direction. When strabismus occurs, one of the eyes works differently and has a problem keeping ocular alignment. 

Proper eye alignment is needed to avoid seeing double, for good depth perception, and to prevent poor vision in the turned eye. When the eyes are misaligned, the brain receives two different images. This may create double vision and confusion. However, over time, the brain will start to ignore the image received from the turned eye.

  • Strabismus can be constant or intermittent, which means it can either be constantly present or only be present at times. Other two types include:
  • Unilateral strabismus occurs when the misalignment affects the same eye.
  • Alternating strabismus happens when your eyes may take turns being misaligned.

Based on the direction of the misaligned eye, there are four types of strabismus:

  • Esotropia: inward turning
  • Exotropia: outward turning
  • Hypertropia: upward turning
  • Hypotropia: downward turning
DID YOU KNOW
Strabismus usually appears during the first three years of age, but cases of adult strabismus are also very common.

Strabismus symptoms

Based on what age the strabismus occurs, different symptoms may appear. In adults, signs of strabismus might include:

  • Weakness in the eye
  • Vision changes (double vision, blurry vision, loss of depth perception)
  • Constant tilting of the head to see an image clearly

Strabismus is one of the most common eye conditions in children. Children can either be born with strabismus or acquire it later. Strabismus should be diagnosed as early as possible to prevent vision loss and be able to take the necessary precautions. Signs of strabismus (crossed eyes) in children can include:

  • The eyes are always turned outward or inward during the first three months of age
  • After the first three months of age, one or both eyes are crossing in
  • Red-eye infection in one eye

If not diagnosed and treated early, strabismus can result in amblyopia, also called ‘lazy eye.’ Amblyopia causes vision to not develop properly in the misaligned eye and can eventually lead to complete vision loss. Another complication is double vision, not to mention the personal side effects of having a misaligned eye.

When do the symptoms of strabismus appear?

By the age of three to four months, the infant’s eyes should be able to focus on small items and remain straight. The baby should easily focus on objects both near and far away. Strabismus is common among infants and usually appears by the time the child is three years old. 

False strabismus can make it seem like the child has a misaligned eye when the eyes are aimed in the same direction. With the baby’s growth and development, the eyes will no longer appear crossed.

What causes strabismus?

As previously explained, strabismus occurs when the six muscles that control our eye movements don’t work correctly. 30% of the children with strabismus have inherited the condition from their family history and have a family member with a similar problem.

  • Down syndrome (20-60% of patients with Down syndrome are affected)
  • Stroke (is the leading cause of strabismus in adults)
  • Head injuries (if the damaged area of the brain is responsible for the control of eye movement)
  • Brain tumors
  • Poor vision in one eye 

Strabismus is one of the most common eye conditions in children. Children can either be born with strabismus or acquire it later. Strabismus should be diagnosed as early as possible to prevent vision loss and be able to take the necessary precautions. Signs of strabismus (crossed eyes) in children can include: 

  • The eyes are always turned outward or inward during the first three months of age
  • After the first three months of age, one or both eyes are crossing in
  • Red-eye infection in one eye

If not diagnosed and treated early, strabismus can result in amblyopia, also called ‘lazy eye.’ Amblyopia causes vision to not develop properly in the misaligned eye and can eventually lead to complete vision loss. Another complication is double vision, not to mention the personal side effects of having a misaligned eye.

How is strabismus diagnosed?

Strabismus is diagnosed after a complete eye examination with an ophthalmologist or optometrist. The exam can include different things, such as:

  • The examination of patient history to determine if any other complications may cause strabismus and affect it.
  • Examination of eye health to determine the overall health of the eye; based on when the patient has been diagnosed, there might already be some damage to the eye.
  • Visual acuity test to measure the visual acuity and determine how much vision is being affected in the misaligned eye.
  • Alignment and focusing tests assess how well the eyes align and move together.

Once all tests are done and completed, based on the diagnosis, your eyecare specialist can discuss with you and suggest treatment options.

Can Strabismus be fixed?

Unfortunately, strabismus cannot be prevented; however, if detected early and properly treated, it can be corrected. When it comes to strabismus treatments, there are several options:

  • Eyeglasses  or contacts
  • Patching: covering the misaligned eye with a patch every day for a few hours can help remind the brain which ‘correct eye’ needs attention. This can sometimes lead to a better alignment of the misaligned eye.
  • Prism lenses: these lenses are thicker than usual lenses and can alter the light that reaches the eye; this results in the eye having to move less to see properly. In some cases, prism lenses can eliminate eye turning.
  • Visual therapy: your eyecare specialist might prescribe a few visual activities to improve eye coordination and eye focusing. These eye muscle exercises can be done with a professional’s help or at home.
  • Eye muscle surgery: this intervention changes the length and position of the muscles around the eye so they don’t look misaligned anymore. After this type of surgery, visual therapy is often advised.
  • Medications 

Based on the severity of the strabismus, some treatments might be more effective than others. Cases of mild strabismus may only require glasses or patching, while severe cases might require eye muscle surgery. 

Can Strabismus be fixed?

infographic describing how strabismus is fixed

Adult strabismus can be treated in various ways; just like for children, not treating strabismus can be extremely dangerous for the eye’s overall health.

Studies show that improvement is possible at any age when it comes to strabismus. The recovery speed might differ, but adults can still achieve great results by doing visual therapy, wearing glasses, and taking all the necessary measurements to improve.

Adult strabismus surgery is also very common, mainly because it is easier for adults to undergo surgery than for children.

False strabismus can make it seem like the child has a misaligned eye when the eyes are aimed in the same direction. With the baby’s growth and development, the eyes will no longer appear crossed.

Glasses for strabismus

When it comes to glasses, it is important to note that there are no special glasses that correct strabismus. 

After consulting with an ophthalmologist, the treatment of strabismus can include wearing corrective lenses. In some cases of mild strabismus, prescription glasses can even correct the alignment. Based on the condition of the eye, the doctor can either suggest prism lenses or not.

Do glasses help with strabismus?

Again, depending on how severe the strabismus is, eyeglasses might be able to correct the alignment and are mainly used in patients with uncorrected refractive errors. 

Although it is impossible to prevent, strabismus can be treated. With the help of an ophthalmologist and if diagnosed in time, being proactive about treatment can prevent vision loss and even correct the misaligned eye. 

If you have more questions about other eye conditions or general eye health, head to our Optical Center to learn more or speak to one of our certified online Opticians.

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