CHOC Children's

Crossed-Eyes (Strabismus)

Picture of a physician using a prism to check for strabismus
Photograph used by permission of
the National Eye Institute, National
Institutes of Health

What is strabismus?

Strabismus, a misalignment of the eyes, is one of the more common eye problems in children, affecting about three percent of children under the age of 6 years. The eyes (one or both) may turn inward, outward, turn up, or turn down. At times, more than one of these conditions are present. Strabismus is also called "wandering eye" or "crossed-eyes."

What causes strabismus?

Experts do not completely understand the cause of strabismus. However, strabismus results from failure of the eye muscles to work together. The brain controls the eye muscles, which are attached to the outside of each eye. There appears to be a higher incidence of strabismus in children with disorders that affect the brain, such as cerebral palsy or hydrocephalus. Strabismus may also occur later in life as a result of an illness, cataract, or eye injury.

All forms of strabismus have been found to cluster in families. Siblings and children of an individual with strabismus may have an increased chance to also develop it, however, a single inherited cause has not been identified.

What are the symptoms of strabismus?

What is amblyopia?

Amblyopia, also called "lazy eye," is a condition in which vision does not develop in an otherwise structurally normal eye. When related to strabismus, usually the child has one weak eye with poor vision and one strong eye with normal vision.

Amblyopia may also result from other eye conditions where one eye focuses better than the other, such as with nearsightedness or farsightedness, or as a result of eye diseases, such as a cataract.

It is normal for a newborn's eyes to move independently and at times, even cross. However, by three months old, an infant should be able to focus on objects and the eyes should be straight, with no turning. Babies by this age have an appropriate social smile and should make eye contact. If you notice that your child's eyes are moving inward or outward, if he/she is not focusing on objects, and/or the eyes seem to be crossed, you should seek medical attention.

The symptoms of strabismus may resemble other medical conditions. Always consult your child's physician for a diagnosis.

How is strabismus diagnosed?

Early detection and treatment can prevent permanent visual impairment. Strabismus is diagnosed during an eye examination. Eye examinations are recommended for all children by the age of 3. However, if your child is having symptoms of strabismus or other eye disorders at any age, an eye examination should be performed.

Treatment for strabismus:

Your child should be referred to an ophthalmologist (eye care specialist) for treatment of this problem. Treatment may include one, or more, of the following:

  • eyeglasses
  • eye drops
  • surgery to straighten the eyes
  • eye patch over the strong eye (if amblyopia is present) to improve the weak eye

Early treatment can prevent potentially permanent visual impairment.

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It is important to remember the health information found on this website is for reference only not intended to replace the advice and guidance of your healthcare provider. Always seek the advice of your physician with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your physician or 911 immediately.

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