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A Closer Look at Strabismus: Can It Cause Cross-Eyed Conditions?

Strabismus is sometimes called being cross-eyed or having a “lazy” eye. It’s a condition that causes your eyes to become misaligned. The result is difficulty seeing correctly and changes to the appearance of your eyes. It’s common in kids, but it can carry on into adulthood without treatment.

Let’s examine the causes of strabismus, the treatments for the condition, and how it’s connected to misaligned eyes.

What Is Strabismus?

Strabismus causes problems focusing both eyes on an object. People with this condition have misaligned eyes, meaning one eye may move in one direction as it focuses while the other does the opposite.

Vision problems caused by strabismus are sometimes constant, but the condition can also manifest intermittently. It sometimes only affects one eye but often causes problems for both.

What Are the Different Types of Strabismus?

There are multiple types of strabismus, including esotropia, exotropia, hypertropia, and hypotropia. Here, we break down each.

Esotropia

Esotropia causes a person’s eyes to turn inward. It’s usually a congenital condition, developing at birth or within the first six months of age. In addition to infantile esotropia, kids can develop accommodative esotropia as toddlers due to farsightedness and eye alignment problems.

Exotropia

Exotropia causes a person’s eyes to turn outward and can be intermittent or constant. In cases of intermittent exotropia, eye drifts occur only at certain times, like when a person is focusing on an up-close object or during eye movement. Constant exotropia causes persistent misalignment that can cause more serious ocular problems.

Hypertropia and Hypotropia

Hypertropia results in one eye turning upward, while hypotropia results in one eye turning downward. Both of these conditions are sometimes called a “lazy eye.” The correct term is amblyopia, so make sure you’re respectful and kind to anyone dealing with this vision problem.

What Causes Strabismus?

We don’t know exactly why certain people develop strabismus, but we do know it can be hereditary. Problems with optical nerves, eye muscles, and neurological issues can also make it difficult to control your eye movements.

Refractive errors like farsightedness and nearsightedness sometimes cause strabismus. In these cases, accommodative esotropia is usually the result of a person’s eyes trying to adjust to changes in the way light enters.

Additionally, there’s a clear connection between strabismus and medical conditions like strokes, head injuries, and cerebral palsy. People with down syndrome are also more likely to deal with poor vision from strabismus.

What Are the Symptoms of Strabismus?

The main symptoms of strabismus are misaligned eyes and double vision. People with strabismus sometimes have a weaker eye and a stronger eye, which can make it hard to focus on close-up objects. In these cases, a person might tilt their head to the side to focus better with their dominant eye.

Strabismus can also cause trouble with depth perception, which can make it hard to drive and stay aware of your environment. When the condition is very severe, it can be hard to achieve independence without treatment.

How Is Strabismus Diagnosed?

The best way to manage strabismus is to diagnose and treat the condition early. Eye issues often develop in childhood, so we recommend taking your kids to visit a pediatric ophthalmologist if you think they might be dealing with strabismus symptoms.

Pediatric ophthalmology is specialized eye care for babies and young children. An optometrist can diagnose conditions that affect a child’s eyes, prescribe medication, and perform surgery, which separates their role from that of a more basic eye doctor like an optometrist.

A pediatric optometrist can test your child for misalignment of the eyes with help from a visual acuity test, a refraction test, an eye alignment test, and, sometimes, an in-depth retinal exam.

Visual Acuity Test

This test measures how well a person sees at certain distances, and it’s a key part of diagnosing and treating strabismus. Since strabismus is often treated with glasses, this test is a precursor to prescribing eyeglasses by helping the doctor determine if their patient is nearsighted, farsighted, or both.

Refraction Test

Once an eye doctor knows whether their patient is nearsighted or farsighted, they use a refraction test to find the perfect prescription for glasses or contact lenses.

This test measures how light enters the eye and how the eye focuses on objects. This helps determine how much vision correction a person will require. You can use the results of this test to order glasses or contacts online.

Eye Alignment Test

This test uses reflecting lights and eye covers to determine how well a person’s eyes align with each other. The test results can confirm that strabismus is the root cause of your vision problems and not another issue.

Retinal Exam

A retinal exam gives your eye doctor a closer look at your retina to check for any irregularities that might be causing vision problems. This exam can rule out other causes of double and blurred vision, like cataracts or glaucoma.

How Is Strabismus Treated?

Glasses and contact lenses are the most common treatment for strabismus, but vision therapy for eye coordination is also a helpful way to ease symptoms and strengthen eye muscles. In some cases, an eye doctor might recommend strabismus surgery, which involves operating on the eye muscles to realign both eyes.

In cases of strabismus where one eye is weaker than the other, eye doctors sometimes encourage their patients to wear an eye patch.

Adjusting to a patch can be tricky, but if it helps you see more clearly, you won’t regret getting used to it. Prism lenses can also be helpful; they transform how light enters your eyes to correct double vision and other refraction issues.

One of the most important aspects of strabismus recovery is sticking with a consistent treatment plan. Once you have recommendations and prescriptions from your eye doctor, make eye care a daily habit. You’ll have more manageable symptoms and clearer vision in the long run.

How To Manage Strabismus

Strabismus may impact how you live, but you can still enjoy life and keep your eyes healthy. Here are some proven methods of managing strabismus to lead a happy, healthy life.

Get Eye Exams Regularly

People with strabismus might need to visit the eye doctor more regularly for prescription updates and checkups. This is especially true for kids with strabismus, as the condition can progress fast. Consistent intervention from an eye doctor is necessary for younger and older children alike.

In cases of adult strabismus, visits to the eye doctor might not need to be so frequent. Regular check-ups to monitor and manage the condition usually happen once or twice every six months, providing peace of mind that you’re on top of your symptoms and have what you need to see clearly.

Wear Glasses or Contacts

While eye muscle surgery is the most extreme treatment for strabismus, glasses are sometimes all you need to correct your vision. If your doctor prescribes glasses or contacts, wear them consistently to keep your eyes from compensating. In addition, if your vision seems blurrier, it might be time for an update to your prescription.

Seek Help and Support

You don’t have to deal with strabismus alone. Support groups, therapy, and daily encouragement from friends and family can improve your experience.

Strabismus can have a profound emotional impact —sometimes without you noticing —and it’s healthy to process those emotions and surround yourself with people who are rooting for you.

Educate Yourself

Knowing what to expect from strabismus can help you confidently navigate your treatment journey. It’s worthwhile to ask your eye doctor plenty of questions and get familiar with your treatment options.

Takeaways for Strabismus

Strabismus is a life-altering condition, and many people deal with it from birth or very early childhood. Luckily, it’s both manageable and treatable.

If you’re dealing with strabismus, make sure you’re following a consistent treatment plan to stay on top of your symptoms and prevent your vision from getting worse. You can still enjoy life and see clearly while living with strabismus — all it takes is some help and support.

Sources:

Strabismus (crossed eyes) | AOA

Strabismus Surgery: Procedure Details & Recovery | Cleveland Clinic

Strabismus Surgery in Children: What to Expect at Home | MyHealth Alberta

Adult Strabismus > Fact Sheets | Yale Medicine