Strabismus is a condition in which the eyes do not properly align, commonly referred to as crossed eyes or wall-eyed. This misalignment may involve one or both eyes turning inward, outward, upward, or downward. It affects approximately 2-4% of young children and, if untreated, can lead to vision problems such as double vision or amblyopia (lazy eye). Strabismus can be classified based on the direction of misalignment, frequency, and whether it affects one (unilateral) or both (alternating) eyes.
Types of Strabismus
Strabismus is categorized by the direction in which the eye turns:
- Esotropia: Inward turning eye (most common in infants)
- Exotropia: Outward turning eye, often appearing between ages 1-6
- Hypertropia: Upward turning eye
- Hypotropia: Downward turning eye
Strabismus can also be classified as constant or intermittent and may vary in severity from a small to a large-angle misalignment.
Causes and Risk Factors
Strabismus results from abnormal functioning of the eye muscles, nerves, or brain centers that control eye movement. Common causes include:
- Neurological conditions affecting the brain’s control over binocular vision.
- Anatomical problems with the eye muscles that impact alignment.
- Uncorrected farsightedness (accommodative esotropia): Eyes strain while focusing on distant objects, leading to crossing.
- Genetic predisposition: A family history of strabismus increases the likelihood of developing the condition.
- Medical conditions such as Down syndrome, cerebral palsy, or stroke, which raise the risk of developing strabismus.
Symptoms of Strabismus
- Noticeable misalignment of the eyes
- Double vision or low vision in one eye
- Tilting the head or frequent squinting
- Eye strain and headaches
- Difficulty making eye contact, which may impact social interactions
Diagnosis of Strabismus
An eye care professional will diagnose strabismus using a combination of tests, including:
- Visual acuity testing to measure clarity of vision.
- Refraction tests to check for refractive errors such as farsightedness.
- Alignment and focusing assessments to evaluate eye coordination.
- General eye health examination to detect underlying medical conditions.
Treatment Options for Strabismus
Treatment for strabismus depends on its severity and underlying cause. Common options include:
- Eyeglasses or Contact Lenses: Can help correct accommodative esotropia caused by uncorrected farsightedness.
- Eye Patching: Used when one eye consistently turns, patching the dominant eye encourages the weaker eye to work harder and regain function.
- Vision Therapy: A personalized program of exercises designed to improve eye coordination, alignment, and focusing abilities.
- Surgical Intervention: In severe cases, eye muscle surgery may be needed to adjust the positioning of the extraocular muscles and improve alignment.
Managing Strabismus
Strabismus is a treatable condition, and early diagnosis improves outcomes significantly. If you or your child show signs of eye misalignment, seek professional eye care to explore the best treatment options and prevent long-term vision issues.