Strabismus is a condition in which one eye does not track with the other eye (crossed eye). It may be constant or intermittent and may alternate between the eyes.
Signs and Symptoms of Strabismus
The most common symptom of strabismus is one eye turning in a different direction than the other eye. In many cases the strabismus may be obvious or very slight and not noticeable without close examination. Patients may not even be aware of the strabismus as the brain is constantly toning out (suppressing) the input from the crossed eye to prevent double vision. Depth perception and 3-D vision require both eyes to be straight and working together so patients with strabismus usually lack in these abilities.
What Causes Strabismus?
Six muscles connect to each eye and work to point the eyes in different directions. They perform a complex balancing act to keep the eyes aligned. Any weakness in these muscles or lack of proper nerve connections to the muscles will cause strabismus. Farsightedness can also cause strabismus. Patients with strabismus are usually born with the condition or develop it at an early age. However strabismus can also develop in adults with system diseases that cause nerve and muscle problems such as Myastenia Gravis, Multiple Sclerosis, stroke, diabetes, nerve palsies, and brain tumors.
How is Strabismus Diagnosed?
Strabismus is often noticed by a parent or Pediatrician. An Optometrist or Pediatric Ophthalmologist should thoroughly exam any child with possible strabismus. They will perform a battery of tests to determine the degree and cause of the misalignment. Regardless of any possible strabismus, every child should have a thorough eye examination by an eye doctor before age four.
How is Strabismus Treated?
Treatment depends on the severity and type of strabismus. If farsightedness is causing the strabismus, glasses can often treat the problem. If the strabismus is intermittent and mild, eye exercises can be prescribed to strengthen the eye muscles and reduce the problem. In cases of more pronounced or constant strabismus, surgery is often required. A pediatric ophthalmologist will need to adjust the length or insertion points of the muscles to get the best alignment. This can involve multiple procedures and will often produce good cosmetic alignment but the eyes will still have limited “binocular” (eyes working together) function so depth perception and 3-D vision will be limited. Strabismus often also involves Amblyopia (lazy eye). Treatment for this problem may require patching in addition to surgery and glasses. If the strabismus is sudden on as an adult, the cause is usually systemic and must be address immediately.
What Steps Should I Take if I Think My Child or I Have Strabismus?
We recommend that all children have a thorough eye examination by an eye doctor by age four to detect any type of strabismus. Any adult with sudden onset strabismus must be seen immediately. Dr. Reinders has 22 years experience in diagnosing strabismus and related conditions.