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Strabismus is misalignment of the eyes. The eyes may appear to cross, or one eye may wander to the side. Strabismus is sometimes called crossed eyes or wall-eyed.
About 4 percent of the U.S. population has strabismus. Left untreated, strabismus can lead to amblyopia or permanent vision loss in children.
The four most common types of strabismus are:
When a child has two healthy eyes, the eye muscles work together to focus on the same object at the same time. The brain combines the two pictures into a single, three-dimensional image, and this image gives us depth perception.
With strabismus, the muscles do not work together. Each eye focuses in a different place. As a result, two different images are sent to the brain. The brain may begin to ignore the weaker eye. If strabismus continues and vision loss in the weaker eye progresses, it can lead to a condition called amblyopia or lazy eye. About one-third of children with strabismus will develop amblyopia.
The cause of most children’s strabismus is unknown, but family history can be a factor.
Symptoms can always be present or come and go. A newborn’s eye may cross or wander. Even if this only happens occasionally, tell your pediatrician if it occurs after your child is 3 months of age. You may notice these symptoms of strabismus in a child as well:
At Riley at IU Health, an ophthalmologist will conduct a complete eye examination of both eyes. Tests may include:
These tests can determine how much the eyes are out of alignment.
If identified and treated early, strabismus can be corrected. The goal of strabismus treatment is to improve eye alignment and allow the eyes to work together better.
An ophthalmologist may fit your child with eyeglasses or suggest eye exercises. Patching or atropine eye drops may be used to treat amblyopia or lazy eye. When the stronger eye is patched or treated with eye drops, it can force the weaker eye to get stronger.
Eye muscle surgery also may be needed, but it will not correct poor vision in a lazy eye. Problems associated with strabismus like lazy eye, ptosis and cataracts are usually treated before surgery. Glasses, patching or other treatment for lazy eye may still be needed after surgery. If amblyopia is not treated by about age 11, it can be permanent.
Many children will have strabismus or amblyopia more than once. This is why an ophthalmologist should monitor your child’s vision for months or even years.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This organization supports improvement of children’s eye care. Their website includes information on eye conditions for patients, families, physicians and other healthcare professionals.
The American Academy of Ophthalmology is the largest national membership association of eye doctors. Parents and caregivers can use their website to learn more about the diagnosis and treatment of strabismus.
Our physicians are committed to excellence in pediatric ophthalmology care, demonstrated through participation in research at the Indiana University School of Medicine. Recent research explores the use of intraocular lens and secondary Artisan lens implants in children as a treatment for cataracts, new drugs to treat glaucoma, new therapies for macular degeneration and treatment of strabismus. We have also completed research in molecular biology of the chemical cycle of vision, neurophysiology of eye movements and physiology of blood flow in the eye.