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Strabismus

Contents of this page:

Illustrations

Crossed eyes
Crossed eyes
Walleyes
Walleyes

Alternative Names    Return to top

Crossed eyes; Esotropia; Exotropia; Squint; Walleye

Definition    Return to top

Strabismus is a disorder in which the eyes do not line up in the same direction when focusing. The condition is more commonly known as "crossed eyes."

Causes    Return to top

Strabismus is caused by a lack of coordination between the eyes. As a result, the eyes look in different directions and do not focus at the same time on a single point.

In most cases of strabismus in children, the cause is unknown. In more than half of these cases, the problem is present at or shortly after birth (congenital strabismus).

In children, when the two eyes fail to focus on the same image, the brain may learn to ignore the input from one eye. If this is allowed to continue, the eye that the brain ignores will never see well. This loss of vision is called amblyopia, and it is frequently associated with strabismus.

Some other disorders associated with strabismus in children include:

Strabismus that develops in adults can be caused by:

A family history of strabismus is a risk factor. Farsightedness may be a contributing factor. In addition, any other disease causing vision loss may cause strabismus.

Symptoms    Return to top

Exams and Tests    Return to top

A physical examination will include a detailed examination of the eyes. Tests will be done to determine the strength of the eye muscles.

Eye tests include:

A neurological examination will also be performed.

Treatment    Return to top

Treatment involves strategies to strengthen the weakened muscles and realign the eyes. Glasses and eye muscle exercises may be prescribed.

If the condition is caused by a lazy eye, the doctor may prescribe an eye patch. Some children may need surgery. For more information on treating lazy eye, see: Amblyopia

Outlook (Prognosis)    Return to top

With early diagnosis and treatment, the problem can usually be corrected. Delayed treatment may lead to permanent vision loss in one eye.

When to Contact a Medical Professional    Return to top

Strabismus requires prompt medical evaluation. Call for an appointment with your health care provider or eye doctor if your child:

Note: Learning difficulties or problems at school can sometimes be due to a child's inability to see the blackboard or reading material.

References    Return to top

Hatt SR, Leske DA, Kirgis PA, Bradley EA, Holmes JM. The effects of strabismus on quality of life in adults. Am J Ophthalmol. 2007 Nov;144(5):643-7.

Update Date: 7/28/2008

Updated by: Manju Subramanian, MD, Assistant Professor in Ophthalmology, Vitreoretinal Disease and Surgery, Boston University Eye Associates, Boston, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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