Crossed eyes, or strabismus, is a condition in which both eyes do not look at the same place at the same time. It usually occurs in people who have poor eye muscle control or are very farsighted.
Six muscles attach to each eye to control how it moves. The muscles receive signals from the brain that direct their movements. Normally, the eyes work together so they both point at the same place. When problems develop with eye movement control, an eye may turn in, out, up or down. The eye turning may occur all the time or may appear only when the person is tired, ill, or has done a lot of reading or close work. In some cases, the same eye may turn each time. In other cases, the eyes may alternate turning.
Proper eye alignment is important to avoid seeing double, for good depth perception, and to prevent the development of poor vision in the turned eye. When the eyes are misaligned, the brain receives two different images. At first, this may create double vision and confusion. But over time the brain will learn to ignore the image from the turned eye. Untreated eye turning can lead to permanently reduced vision in one eye. This condition is called amblyopia or lazy eye.
Some babies' eyes may appear to be misaligned, but they are actually both aiming at the same object. This is a condition called pseudostrabismus or false strabismus. The appearance of crossed eyes may be due to extra skin that covers the inner corner of the eyes or a wide bridge of the nose. Usually, the appearance of crossed eyes will go away as the baby's face begins to grow.
Strabismus usually develops in infants and young children, most often by age 3. But older children and adults can also develop the condition.
People often believe that a child with strabismus will outgrow the condition. However, this is not true. In fact, strabismus may get worse without treatment. An optometrist should examine any child older than 4 months whose eyes do not appear to be straight all the time.
Strabismus is classified by the direction the eye turns:
Other classifications of strabismus include:
Strabismus can be caused by problems with the eye muscles, the nerves that transmit information to the muscles, or the control center in the brain that directs eye movements. It can also develop due to other general health conditions or eye injuries.
Risk factors for developing strabismus include:
Many types of strabismus can develop in children or adults, but the two most common forms are:
An optometrist can diagnose strabismus through a comprehensive eye exam. Testing for strabismus, with special emphasis on how the eyes focus and move, may include:
Using the information obtained from these tests, along with results of other tests, your optometrist can determine if you have strabismus. Once testing is complete, your optometrist can discuss treatment options.
People with strabismus have several treatment options to improve eye alignment and coordination. They include:
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