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Strabismus (Crossed Eyes): Causes, Symptoms, and Treatments

Strabismus, also known as crossed eyes, is a condition where the eyes point in different directions. While one eye looks forward, the other may turn inward, outward, up, or down. This misalignment prevents the eyes from working together, leading to vision problems such as blurred or double vision. In some cases, it can also cause amblyopia, or lazy eye, where one eye develops poor vision.

Strabismus is most common in children but can also affect adults, especially those with certain medical conditions. It's essential to identify and treat strabismus early to prevent long-term vision problems.

Types of Strabismus

Doctors classify strabismus based on the direction of the misaligned eye:

  • Esotropia: when the eye turns inward

  • Exotropia: when the eye turns outward

  • Hypertropia: when the eye points upward

  • Hypotropia: when the eye points downward

Strabismus can also be described as intermittent (occurring sometimes) or constant, and it may affect one eye (unilateral) or alternate between eyes.

Causes of Strabismus

Strabismus can result from problems with the eye muscles, nerves, or the brain's control of eye movement. Risk factors include:

  • Family history of strabismus

  • Farsightedness or nearsightedness

  • Certain medical conditions (e.g., Down syndrome, cerebral palsy, hydrocephalus)

  • Stroke, brain tumor, or head injury (in adults)

  • Graves' disease (a thyroid condition)

Symptoms of Strabismus

In children, parents or caregivers may notice:

  • Eyes that look misaligned

  • Eyes that don't move together

  • Frequent blinking or squinting

  • Tilting the head to look at things

  • Closing one eye to focus

Other symptoms in both children and adults include double vision, headaches, eye strain, and difficulty reading.

Diagnosing Strabismus

An eye doctor (ophthalmologist) can diagnose strabismus through a comprehensive eye exam. Tests may include:

  • Visual acuity test to measure vision clarity

  • Refraction test to determine the need for glasses

  • Alignment and focus tests

  • Dilated pupil exam to check for underlying eye diseases

Additional tests, such as blood tests or MRI scans, may be necessary to identify the underlying cause.

Treating Strabismus

Treatment for strabismus depends on the cause, severity, and the person's age. Options include:

  • Glasses or contact lenses to correct vision problems

  • Prism lenses to help align images and reduce double vision

  • Patching or eye drops to strengthen a lazy eye in children

  • Botox injections to temporarily relax eye muscles

  • Surgery to adjust eye muscle tension and improve alignment

  • Vision therapy exercises to improve eye coordination and focus

Early treatment is crucial to prevent long-term vision problems, but it's never too late to seek help for strabismus.

Complications of Untreated Strabismus

If left untreated, strabismus can lead to:

  • Amblyopia (lazy eye)

  • Persistent double vision

  • Blurry vision

  • Poor depth perception

  • Eye strain, fatigue, and headaches

  • Low self-esteem and embarrassment

In adults and older children, sudden onset of strabismus may indicate a serious underlying condition, such as a stroke or brain tumor.

If you suspect that you or your child has strabismus, consult an eye doctor for a proper diagnosis and treatment plan. Early intervention can help prevent long-term vision problems and improve overall quality of life.

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