Strabismus is a vision problem in which the eyes are misaligned, meaning that they do not look at the same point at the same time.  For example, while one eye looks straight ahead, the other may look up, down, in, or out.  Strabismus is sometimes called cross-eyes, walleye, wandering eye, deviating eye, or squint.  Strabismus may also be called "lazy eye," but this term is more commonly associated with poor vision resulting from amblyopia.

Strabismus may affect vision all of the time (constant) or some of the time (latent or intermittent).  Without treatment, strabismus that initially comes and goes may become more constant.

Strabismus usually begins in early childhood--up to five percent of children have it--for reasons that are unclear.  It often runs in families, and many children are born with it.  Many patients carry their eye misalignment with them into adulthood.  More rarely, some people develop eye misalignment as adults.  Head injury, loss of vision, severe high blood pressure, diabetes, an eye or brain tumor, Graves' disease, stroke, and various muscle and nerve disorders (myasthenia gravis, multiple sclerosis) can cause strabismus in an adult. 

Adults with eye misalignment often complain of double vision, or diplopia.  Children usually do not develop double vision with eye misalignment, since the visual system is maturing and they can "shut-off" the second image.  Adults, on the other hand, have a mature system that cannot ignore the second image.

How Is Strabismus Treated?

Many adults with eye misalignment believe that nothing can be done for their eye misalignment.  This is not true.  Our team of experts has many tools at their disposal to reduce or eliminate eye misalignment and double vision in many adults.  Studies have shown that eye-muscle surgery in adults can be quite effective.

In addition to surgery, other ways of treating strabismus are:

• Prismatic Glasses.  If the eyes are only slightly misaligned and double vision is present, wearing prismatic glasses can reduce or eliminate the double vision.  The prisms do not cure the problem but instead allow the patient to have single vision while the glasses are on.    
• Chemical Injections (BOTOX).  In a few, select cases of eye misalignment, injecting botulinum toxin, BOTOX, into the eye muscles may help.   Botox is injected into the muscles that control the movement of the eyes to temporarily weaken the overactive eye muscle that is pulling too hard.  After several months, the muscle regains its function.
• Drug treatments.  The doctor may use certain drugs, often in the form of eyedrops, as part of the treatment. Miotics (such as ecothiopate iodide) and atropine affect muscles in the eye that control the pupil and the eye's ability to focus.
• Eye exercises (orthoptic exercises).  Exercises may occasionally be used as a supplement to other treatments, such as surgery.  However, eye exercises alone are not helpful in most cases of strabismus.

Is It Too Late to Treat My Strabismus?

Patients often ask if it is too late to treat their strabismus.  Thomas Eye Group believes that everyone deserves a chance!  Age should not be a deterrent, although treatment under age six (especially before two) is ideal and yields better results than later treatment.  After age six, the patient's age is not important.  Every attempt should be made to improve strabismus, even though treatment might not be as effective after age six, and definitely requires more work.  

If you would like to be tested for strabismus, please call us for an appointment, or use our online appointment request form.

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