Strabismus

Strabismus is a misalignment of the eyes. This can appear as an inward (cross-eyed), outward, or vertical eye turn. Normally, the six muscles surrounding each eye work as a team and allow both eyes to point at the same object. In strabismus, these muscles do not work together which results in the eyes pointing in two different directions.

Strabismus is classified by the direction(s) of the eye turn:

  1. Exotropia – outward
  2. Esotropia – inward
  3. Hypertropia – upward
  4. Hypotropia – downward

Strabismus can be seen in patients with a high glasses prescription.  It can also be associated with medical conditions such as brain injury, strokes, Down syndrome, and cerebral palsy.

If strabismus remains untreated, it can lead to a condition called amblyopia, or “lazy eye”.

Common Symptoms

  • Cross-eyed, or eyes that look misaligned
  • Squinting or frequent blinking, especially in bright sunlight
  • Closing or covering one eye
  • Presence of a head tilt
  • Poor depth perception
  • Double vision
  • Blurred vision in affected eye
  • Headaches
  • Eyestrain
  • Eyes not tracking together

Treatment Options

Glasses or contact lenses will be given for any underlying prescription.  In some cases, prism may be added to help the eyes work together.

Optometric vision therapy can be done to promote “binocular” vision, or using both eyes together. The prognosis of vision therapy is case dependent.

If indicated, a referral for surgical correction of the strabismus may be recommended. Often, optometric vision therapy is needed before and/or after surgery is performed to stabilize the “binocular” or eye teaming skills which will help better maintain ocular alignment.

Exam / Visit Expectations

Typically, the evaluation requires two parts.

  • Comprehensive eye exam includes a refraction (determination of glasses prescription) and a dilated ocular health evaluation.
  • Visual skills evaluation specifically assesses binocular (eye-teaming), oculomotor (eye-tracking), and accommodation (eye-focusing) function to determine the appropriate treatment option.

Surgical consultation with our expert strabismus surgeon to determine if surgical correction is an option

 

Patient Resources or at home actions

College of Optometrists in Vision Development

The Optometric Extension Program Foundation

Neuro-Optometric Rehabilitation Association