The brain controls six muscles that are attached to the eye, which are responsible for moving the eye in multiple directions. The eye muscles must work together in coordination to align the eyes on a target and allow for that target to be seen as a single, clear image. Strabismus is a condition where one or both eyes are pointed in different directions due to a misalignment of the eye muscles. This is commonly known as a “crossed eye” or “wandering eye.” The misaligned direction can be in, out, up, or down. The eye turn may always be present, or the turn may come and go depending on the time of day or activity. In some cases, the misaligned eye is always the eye that is turned, while in other cases the eye turn may alternate between the two eyes.
Strabismus most commonly presents in infancy or childhood and if left undetected or untreated, can lead to a condition called amblyopia. Amblyopia, also known as lazy eye, is a condition that occurs when the visual pathway to the brain is not developed properly. Strabismus can sometimes occur in adulthood, causing the person to experience double vision, i.e. seeing two images while looking at one object. However, in a child with strabismus, the brain often ignores the image coming from the eye that is misaligned. Children are often unable to articulate or recognize there is something wrong with the visual system. When the eye is misaligned in strabismus, the brain does not receive the signal that is necessary for that particular eye to see. There is a risk for reduced vision that is unable to be corrected with glasses, if appropriate treatment is delayed. If treatment is initiated as early as possible in childhood, there is a better chance for the eye to achieve proper alignment and development.
Treatment for strabismus in children can vary but may include wearing glasses to correct farsightedness. Patching or blurring the normal eye may be recommended to strengthen the weaker eye by forcing it to be used. Other treatment options may include prism or vision therapy exercises. Some cases require an eye muscle surgery to correct the alignment of the eyes. Strabismus can be diagnosed by an eye care provider, an optometrist or ophthalmologist, during a comprehensive eye examination. The American Optometric Association recommends an eye examination between 6 months and 12 months of age, between the ages 3 and 5, and once before first grade, or as recommended by an eye care provider. It is also recommended that a child receive a comprehensive eye examination immediately if an eye turn is noticed by a parent, caretaker, or other healthcare professional.
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Here are some additional resources for this condition:
Prevent Blindness- https://www.preventblindness.org/strabismus
American Optometric Association- https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/strabismus
American Optometric Association- https://www.aoa.org/patients-and-public/caring-for-your-vision/comprehensive-eye-and-vision-examination/recommended-examination-frequency-for-pediatric-patients-and-adults
American Academy of Ophthalmology- https://www.aao.org/eye-health/diseases/what-is-strabismus