Strabismus

Often referred to as “cross eyed,” people who suffer with the visual impairment strabismus are not able to align both eyes simultaneously under normal conditions. One or both eyes may turn out, in, down, or up. The eye may be turned in this direction constantly or intermittently. When the eye turns intermittently, it is typically under certain conditions such as in times of stress or illness.

Approximately 3-5% of children have strabismus; many of these children will have double vision because of the misalignment of the two eyes in relation to each other. To avoid double vision, the brain completely disregards the image of one eye. If left untreated, strabismus may result in loss of vision.

Causes and Types of Strabismus

Strabismus may be congenital or acquired. Actually, instead of occurring congenitally, it will occur within the first 1-6 months of life. Rarely is strabismus detected at birth. Those with acquired strabismus will develop the condition after the six-month mark. Risk factors for infantile (congenital) strabismus include:

Family history
Down Syndrome (genetic disorder)
Crouzon Syndrome (genetic disorder)
Prenatal alcohol or drug exposure
Low birth weight
Premature birth
Congenital eye defects
Cerebral Palsy

Acquired strabismus can develop over time or acutely; causes include:

Tumors
Head trauma
Cerebral Palsy (neurologic condition)
Spina Bifida (neurologic condition)
Viral infections
Acquired eye defects

Diagnosis and Detection of Strabismus

Strabismus can be detected during a well-child checkup; physical exam should include an evaluation of visual acuity, pupil reactivity, and extraocular movement ability. A neurological examination of the child’s cranial nerves is also very important. The corneal light reflex test is used and is a good screening test, but this diagnostic tool is not sensitive enough to detect very small deviations. The “alternate cover” and “cover-uncover” tests are also performed to diagnose strabismus.

Treatment of Strabismus

Treatment of strabismus, as with most eye conditions, varies from patient to patient but typically includes any of the following (or some combination):

Wearing an eye patch
Eyeglasses or contact lenses
Eye exercises
Topical agents
Surgical repair to align eyes

Permanent vision loss can occur if strabismus is not treated in time.

If you would like to learn more about strabismus or would like to have your child tested for this visual impairment, please contact an experienced eye doctor in your area.