Crossed-eyed? Your child may have strabismus
Strabismus is an ocular condition commonly diagnosed in infants, toddlers, and children in which the eyes are misaligned.
Each eye has six muscles that need to move in perfect unity to have optimal vision. Abnormal alignment of the eyes can be very noticeable or subtle, depending on the degree of the problem. The eyes can appear irregular all of the time, some of the time, or may only seem abnormal when the child looks in a particular direction.
In order for a person to see well, the eyes need to be in alignment. When they are not, each eye will focus on a different image. Because the brain cannot interpret two images at once, it will effectively shut off one of the eyes. Over time, this eye will learn not to send images to the brain, leading to a permanent loss of vision in the eye. Loss of vision due to strabismus is called amblyopia.
Strabismus can be congenital, meaning that it is present at birth or it can develop later. Similarly, it can exist alone or be part of other medical conditions. Most often, there is no known cause for a child’s strabismus. A family history of strabismus is a risk factor for a child having strabismus.
Your child’s pediatrician will look for strabismus as part of the well-child exams. They will attempt to visualize the alignment of the eyes as well as to watch the eyes as they look around the room. Some pediatricians use specialized machines that do not require a child’s participation in order to screen for strabismus. A nurse or medical assistant will use a machine similar to a large camera to capture an image of the child’s eyes. The machine can detect irregularities in vision.
If an irregularity is detected, it is important for the child to be evaluated by an ophthalmologist, preferably a pediatric ophthalmologist. An ophthalmologist is a medical doctor trained to diagnose and treat strabismus. Initial treatment includes corrective lenses, eyeglasses if needed, drops, as well as patching of one of the eyes in order to strengthen the muscle of the weaker eye. In some cases, surgery is necessary. Strabismus is treatable, but as a parent or caregiver, it is important to bring any concerns regarding vision to your child’s doctor as soon as possible.
Reviewed by Dr. Sara Connolly, February 2019
Takeaways
- Strabismus is a misalignment of the eyes.
- Left untreated, strabismus can lead to loss of vision in one eye.
- An ophthalmologist is a medical doctor trained to diagnose and treat strabismus.
- Talk to your child’s doctor if you have any concerns about their vision or eye movements.
This was my little guy! I can’t recommend strongly enough that if you find yourself in this position, do your best to see a pediatric ophthalmologist. They have done additional training in working with (and operating on) children. As you can imagine, an in-depth eye exam on a baby/toddler is no easy task. A pediatric ophthalmologist will have an office with equipment geared specifically for kids. It is amazing to see how quickly they work and what they can figure out from such child-oriented tests. I’ve had friends in similar situations as me who brought their children to adult ophthalmologists, and to hear how their experiences went was saddening.