Crossed Eyes (Strabismus)

Prevention

Strabismus cannot be prevented. However, complications of strabismus can be prevented if the problem is detected early and treated properly. Children should be monitored closely during infancy and the preschool years to detect potential eye problems, particularly if a relative has strabismus.

The American Association for Pediatric Ophthalmology and Strabismus, the American Academy of Pediatrics, and the American Academy of Family Physicians recommend that at a minimum all children be screened for eye health before age 6 months, regularly during each check-up, and again between 3 and 5 years of age by a pediatrician, family practitioner or ophthalmologist.

Routine vision screening for young children includes testing for strabismus, usually using the light reflex for infants, and cover testing for preschool-age children. Some health care professionals screen for vision problems with a special camera that takes instant pictures of a child's eyes. Crescents of light reflected off the eyes can indicate strabismus or other eye problems including nearsightedness, farsightedness and cataracts.

Treatment

The primary goal of treatment is to preserve or restore as much visual function as possible. Treatments vary, depending on the type and cause of strabismus. Glasses are used to correct vision in the weaker eye. A patch can be worn over the preferred eye to force the child to use the weaker or suppressed eye. Eye drops are used to temporarily blur the vision of the preferred eye for the same purpose. Exercises may be prescribed to strengthen specific eye muscles. Forcing a child to use the weaker eye can improve sight by reinforcing the connection between the eye and the brain.

Surgery to tighten or loosen specific eye muscles usually is required to realign the eyes. This short operation typically is done under general anesthesia and may involve one or both eyes. Occasionally, the first surgery doesn't align the eyes completely and additional surgery is needed.

In some cases, surgery can be avoided by using a relatively new technique in which a drug is injected into one or more eye muscles to temporarily paralyze the muscle. While one muscle is relaxed, the opposing muscle can tighten, shifting the alignment of the eye. Although the effect of the medication eventually wears off, the opposing muscle that has tightened remains that way, often making the correction permanent.