Strabismus is a condition in which a person’s eyes are not correctly aligned. Often referred to as “lazy eye,” strabismus typically presents itself with one eye aligned and moving regularly and the other settled pointing up or down, or off center to the left or right. The afflicted eye may alternate between one and the other; and the position of the eye may change, moving from properly aligned to off-center and then back again. There are several causes of strabismus. It’s found more often in children and can be treated with minimally invasive techniques. Lazy eye occurs in about 4 percent of American children. Although rare, Strabismus can also occur later in life.

Strabismus or amblyopia?

Technically, strabismus refers to being cross-eyed, while amblyopia indicates “lazy eye” or an eye that drifts to the side. Strabismus is the most common cause of lazy eye, resulting in one eye that moves inward or outward. However, a lazy eye may also be due to one eye’s vision not being fully developed and can occur even without the cross-eyed presentation of strabismus. The underdeveloped muscles resulting in strabismus allow the eye to drift, creating vision problems. In amblyopia, the vision problems come first, demonstrated by the eye’s inability to focus properly.

Effects of strabismus on the brain

An unfocused or misaligned eye causes more problems than the difficulty focusing and vision impairment. The weak muscles of strabismus cause the brain to quit receiving input from the afflicted eye. Your brain will only be tracking input from the healthy eye, which can result in off-balance movement or depth perception issues in the body. As your brain stops receiving data from the unfocused eye, the neural pathways between the eye and the vision center of the brain begin to deteriorate or cease to form. In children, especially, with their developing minds, the result is poor vision in the affected eye as a result of lack of stimulus from the brain.

Common types of strabismus

Infantile esotropia occurs in children under two. Babies’ eyes have difficulty focusing and tend to drift, especially for those predisposed to this condition. Children two years and older are more likely to have accommodative esotropia, where the affected eye turns inward when the child focuses. This may occur when the child is looking at things very closely. Extropia, or an outward turning eye, occurs when the child focuses on things at a distance. Parents may notice that the eyes tend to drift more if the child is daydreaming, ill, or tired. They may also tend to squint more in the sunlight and have a harder time focusing in bright light.

Risk factors for childhood strabismus

Although there is no exact cause for strabismus, there are some pre-existing conditions that increase the likelihood of it developing. Younger children are typically afflicted more often, as the six muscles that control the eye aren’t as fully formed. Those with cerebral palsy, Down syndrome, Hydrocephalus, brain tumors, and those born prematurely stand a higher chance of strabismus developing. Children develop muscle control over the eyes in early childhood, and those with medical conditions that affect muscle development may see a decrease in the ability to have proper motor skills in the eye.

Early detection of strabismus

Although many of the risk factors for strabismus, such as congenital disabilities, genetic disorders, or a stroke, may not be prevented, those who do have a family history of these conditions should be aware of the heightened chance for strabismus. If you notice our young child with vision difficulty, regular ophthalmologist check-ups should be part of your preventative medical treatment. With early detection, strabismus is very treatable. The muscle weakness that causes strabismus in younger children can easily be treated if caught early enough.

Signs and symptoms of strabismus

Early signs of strabismus may include several things – if you notice yourself or your loved one developing these symptoms, a visit to the eye doctor for clarification a treatment program is wise. One eye out of focus and drifting in a different direction that the other is an obvious sign, as is an eye that is simply pointing in a different direction. Other, more subtle signs include frequent blinking, rubbing the eyes, or depth perception, and headaches. The individual may also experience double vision or split vision, or experience seeing unstable or moving images.

Adult-onset strabismus risk factors

Although strabismus is more common in children, especially younger ones, several chronic health conditions can lead to strabismus. Graves disease, Noonan syndrome, Prader-Willi syndrome, and diabetes can all contribute to the deterioration of the muscles around the eye. In addition to genetic components, a stroke or shellfish poisoning can cause strabismus. Head injuries, accidents, or concussions may result in an inflicted case of strabismus. If you’ve experienced any of these, consult with your ophthalmologist.

Treating strabismus in children

Early detection of strabismus in children makes the condition more easily treated without invasive procedures. An eye patch or corrective glasses may help the child develop the proper muscle strength in the weaker eye to correct the vision problems naturally. As the affected eye gains more control, the data it sends to the brain becomes easier to process. This leads to higher functioning neurons and communication between the brain and the eye. As the lazy eye corrects itself, the stronger eye begins to work in tandem with it, thus correcting the child’s vision.

Conventional treatment for strabismus

For adults who experience strabismus, treatment may be a little more comprehensive. Vision correction, including lenses and eye patches, along with lenses with prisms can help. There are eye drops that make your strong eye’s vision blurry, thus forcing the weaker eye to focus better. If these treatments are unsuccessful, then surgery to correct the problem would be the next step. The usual surgery is minimally invasive, with a small cut near the eye to correct the position of the eye muscles. While many people recover fully from surgery, others may still need corrective glasses or multiple operations.

Precautions with strabismus

Although you or your child may experience some of the symptoms of strabismus, it is important that you don’t diagnose this condition without a visit to a professional ophthalmologist. They will recommend the best course of action to correct the vision, which will be different for each individual. It is critical to seek treatment as early as possible. Crossed eyes don’t’ go away on their own, and left untreated; strabismus can lead to permanent vision loss.