By Francois van der Merwe B(Optom) UJ

Strabismus is a condition in which your two eyes do not line up, look in different directions and are not focusing on the same object.

It is a condition more common in children but can also occur later in life. When it occurs later in life it can be due to a variety of underlying conditions like cerebral palsy or stroke.

Strabismus can usually be corrected with corrective lenses, surgery, or a combination of both.

What to look out for

If you have strabismus, your eyes might point inward or outward or focus in different directions. You may also suffer from the following:

  •  impaired vision

  • double vision

  • decreased depth perception

  • eyestrain and headache

Your symptoms may be constant or appear only when you are tired or not feeling well.

What are the causes of strabismus?

Strabismus occurs either due to nerve damage or when the muscles around your eyes do not work together because some are weaker than others. When your brain receives a different visual message from each eye, it ignores the signals coming from your weaker eye.

If your condition is not corrected, you may lose vision in your weaker eye.

Often the underlying cause of strabismus in children is unknown. Infantile esotropia is a type of strabismus that appears in babies during their first year of life.

Esotropia runs in families and usually requires surgery to correct. Acquired esotropia occurs in children usually between the ages of 2 and 5.  Spectacles can usually correct it.

Strabismus that presents later in life is usually caused by physical disorders like eye injuries, cerebral palsy, or stroke. You may also develop strabismus if you have a lazy eye or are farsighted.

How is strabismus diagnosed?

To prevent vision loss, early diagnosis, and treatment for strabismus is important. If you develop symptoms, make an appointment with an optometrist who will perform a series of tests which may include

  • a corneal light reflex test to check for crossed eyes

  • a visual acuity test to determine how well you can read from a distance

  • a cover/uncover test to measure your eye movement and deviation

  • a retina exam to examine the backs of your eyes

If you have other physical symptoms along with strabismus, your optometrist might refer you to an ophthalmologist to examine your neural and nervous systems for other conditions as well. 

It is common for newborn babies to have strabismus. If your baby presents with strabismus that persists beyond 3 months of age, make an appointment with your doctor.

How is strabismus treated?

Your recommended treatment plan for strabismus will depend on the severity and underlying cause of your condition. If your strabismus has resulted from a lazy eye, your optometrist, or ophthalmologist may have you wear a patch over your stronger eye to force the muscles of your weaker eye to work harder.

Other potential treatments include:

  • eye exercises

  • corrective lenses, such as spectacles or contact lenses

  • surgery on certain eye muscles, particularly if corrective lenses have not corrected the condition

If your strabismus is caused by an underlying medical condition, such as a brain tumor or stroke, your doctor may prescribe medication, surgery, or other treatments.

What is the long-term outlook for strabismus?

Often strabismus can be corrected with corrective lenses, eye patches, surgery in rare cases, or by other modalities.

It is important to seek treatment right away to lower your risk for vision loss. After you have received treatment, watch your eyes for changes. In some cases, the condition may come back.

If your strabismus is caused by an underlying condition, early detection and treatment will increase your chances for recovery 

Ask your optometrist for more information about your specific condition and treatment options.