Strabismus (Crossed Eyes)

Strabismus, commonly known as crossed eyes, is a condition in which the eyes fail to maintain proper alignment when looking at an object; one eye looks in one direction while the other eye looks in another. The cause remains unclear, but it’s suspected that it is caused by either an anatomical or a neurological problem, meaning it may originate in the muscles of the eyes or it may originate in the nervous system which controls the eye muscles. 

Risk Factors for Strabismus
General risk factors for strabismus include:
  • A family history of strabismus
  • A neurological disorder, whether it be congenital or in adulthood (e.g., history of stroke)
Strabismus produces the following symptoms:
  • Misalignment of the eyes when focusing on an object; one eye looks in one direction while the other eye looks in another. It can effect either one or both eyes, and can occur either intermittently or consistently.
  • Changes in visual acuity occurring from congenital strabismus; visual acuity occurs as a result of not utilizing the affected eye properly, thus making it weaker than the other.
  • Double vision (diplopia); this is not a consequence of congenital strabismus, but occurs with strabismus as an adult.
Diagnosing strabismus will involve a general eye examination with the addition of a special strabismus test, which is used to determine if there is misalignment and to check if the eyes move in synchronization. The doctor will also look for symptoms that suggest a neurological disorder.
Strabismus is categorized based on the following:
  • Strabismus is categorized based on which direction the eye turns: esotropia – inwards; exotropia – outwards; hypertropia – upwards; hypotropia - downwards  
  • Strabismus classified by cause such as nerve degeneration; cranial nerves III, IV, and IV are impaired.
  • Strabismus further diagnosed as Brown Syndrome (limited normal movement of the eye; is congenital or acquired), Duane Syndrome (horizontal eye movement limitation; is congenital).

Treatment of strabismus involves correcting the crossed eyes in order to increase visual acuity. This can be done through vision therapy, prescribing corrective eyeglasses, prescribing prism glasses, or eye surgery, all depending on the patient’s specific condition.
 

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