Cross-Eyed (Strabismus)
Strabismus, commonly known as crossed eyes, is a condition where the eyes don't align properly. One or both eyes may turn inward, outward, upward, or downward, affecting vision and depth perception.
⚠️ Warning Signs - Seek Immediate Medical Attention
- Sudden onset of crossed eyes in adults
- Eye crossing accompanied by severe headache
- Double vision with nausea and vomiting
- Eye misalignment after head injury
- Sudden vision loss with eye crossing
- Eye pain with movement
- Pupil size differences between eyes
- Drooping eyelid with eye crossing
- Signs of stroke (facial drooping, arm weakness, speech difficulty)
Common Causes of Crossed Eyes
Childhood Causes
- Congenital strabismus (present at birth)
- Farsightedness (hyperopia)
- Weak eye muscles
- Nerve problems affecting eye muscles
- Genetic factors
- Premature birth
- Down syndrome
- Cerebral palsy
- Retinoblastoma (eye cancer)
Adult-Onset Causes
- Stroke
- Head trauma
- Brain tumors
- Thyroid eye disease (Graves' disease)
- Myasthenia gravis
- Diabetes-related nerve damage
- Multiple sclerosis
- Brain aneurysm
Types of Strabismus
- Esotropia: Eyes turn inward
- Exotropia: Eyes turn outward
- Hypertropia: One eye turns upward
- Hypotropia: One eye turns downward
- Alternating: Eyes take turns being misaligned
- Intermittent: Occurs only sometimes
Risk Factors
- Family history of strabismus
- Significant refractive errors
- Medical conditions affecting muscles or nerves
- Eye injuries
- Previous eye surgery
- Cataracts
Associated Symptoms
Visual Symptoms
- Eyes pointing in different directions
- Double vision (diplopia)
- Blurred vision
- Depth perception problems
- Need to turn or tilt head to see clearly
- Closing one eye to see better
- Squinting
- Eye strain
Physical Symptoms
- Headaches
- Eye fatigue
- Difficulty reading
- Problems with eye-hand coordination
- Clumsiness or bumping into objects
- Difficulty with sports or driving
Diagnosis
Eye care professionals diagnose strabismus through:
- Comprehensive eye exam: Testing visual acuity in each eye
- Cover test: Observing eye movement when one eye is covered
- Light reflex test: Checking if light reflects equally from both eyes
- Retinal exam: Examining the back of the eyes
- Visual field testing: Checking peripheral vision
- Eye movement testing: Assessing how eyes track objects
- 3D vision testing: Evaluating depth perception
- Brain imaging: MRI or CT scan if neurological cause suspected
Treatment Options
Non-Surgical Treatments
- Eyeglasses or contact lenses: Correct refractive errors
- Prism lenses: Help align images seen by each eye
- Eye patching: Strengthen the weaker eye
- Eye exercises: Improve eye coordination
- Vision therapy: Supervised eye training program
- Botox injections: Temporarily weaken overactive eye muscles
- Orthoptic exercises: Improve binocular vision
Surgical Treatment
- Eye muscle surgery: Adjust muscle length or position
- Adjustable suture surgery: Fine-tune alignment after surgery
- Minimally invasive techniques: Smaller incisions
- Multiple surgeries: May be needed for optimal results
- Combination approaches: Surgery with other treatments
Prevention and Management
- Early eye exams for children (by age 3)
- Regular vision screenings
- Prompt treatment of eye conditions
- Protect eyes from injury
- Manage underlying health conditions
- Follow prescribed vision therapy exercises
- Wear prescribed corrective lenses consistently
- Monitor children's visual development
- Address vision problems early
- Maintain good overall health
- Regular follow-up with eye care provider