When your eyes do not line up or align with one another, or when one eye is turned in a direction that is different from the fellow eye, you have strabismus (misaligned eyes). Ideally, the 8 muscles that regulate eye movement collaborate and point both eyes in the same direction. If you have strabismus, you would have problems with eye movement control as well as problems with eye alignment. It is estimated that 4% of the U.S. population, or about 13 million people, have strabismus .
Strabismus can be classified based on the direction of the turned or misaligned eye:
To better identify the cause and treatment of strabismus, consider the following questions.
There are various types of strabismus. The two most prevalent types are:
Infantile esotropia is a third kind of strabismus that is characterised by a significant amount of inward turning of both eyes. This condition usually happens in infants under 6 months of age, particularly when the child is looking far away and up close. While inward turning may start on an irregular basis, it can become increasingly regular. Surgery on the muscles of one or both eyes to address the alignment is the treatment for this type of strabismus.
Most strabismus is caused by an abnormality of the neuromuscular control of eye movement. Oftentimes, strabismus is inherited, with about 30% of children with strabismus having a family member with a similar problem.
Other conditions linked to strabismus include:
A 3 to 4-month-old infant’s eyes should be able to concentrate on small objects, and the eyes should be straight and well-aligned. A 6-month-old infant should be able to fixate properly on both nearby and faraway objects.
While strabismus most often surfaces by the time a child reaches the age of 3 years old. Older children and even adults can develop strabismus. The abrupt manifestation of strabismus, particularly with double vision, in an older child or adult could allude to a more deep-seated neurologic disorder. Seek immediate attention if this is observed.
Note that a symptom called pseudostrabismus (false strabismus) can make it look like an infant has esotropia (inward turning of the eye/s) when reality has it that the eyes are towards the same direction. Pseudostrabismus can be due to extra skin enveloping the inner corners of the eyes and/or a flat nasal bridge. The eyes will no longer appear crossed once a baby grows older. Pseudo vs an actual strabismus can be ruled out with a simple test conducted by an eye care professional.
If you are older than 4 months of age and seem to have strabismus, you should have a comprehensive eye examination by a paediatric eye care professional. The examination may include the following:
The treatment for strabismus can include:
Subtle changes may go unnoticed and only picked up by a trained professional, making regular comprehensive eye checks all the more important for timely identification, possible interventions and/or referrals to the respective health care professional when strabismus is observed.
 “Strabismus (crossed eyes): Types, causes, symptoms & treatment,” Cleveland Clinic. [Online]. Available: https://my.clevelandclinic.org/health/diseases/15065-strabismus-crossed-eyes. [Accessed: 31-Aug-2022].
Explore our specifically designed products and services backed by eye health professionals to help keep your children safe online and their eyes healthy.