Making Sense of Strabismus


It stands to reason that the more complicated a system, the longer it takes to develop. That’s why our vision takes the first few years of our lives to reach maturity. By the age of 6 or 7, a child’s eyes should be able to focus on an object simultaneously, which is called convergence.


However, for some children, the alignment necessary for both eyes to work together doesn’t occur, usually owing to a neurological or anatomical problem that interferes with development (although there may be a genetic component as well). Strabismus is the term for when one eye turns away, whether inward, outwards, up or down. It’s also known as turned or crossed eyes, or squint. When a child has strabismus, he or she won’t have convergence of sight, which can lead to double vision or amblyopia (also known as ‘lazy eye’).


That’s why it’s important to check for the signs of strabismus when a child is younger than 6, so that treatment can begin while the eye is still developing and the misalignment can be corrected. If not, the brain will start to favour the visual input from just one eye, as it cannot reconcile the images coming from two different directions. This is the root cause of amblyopia.


Strabismus can be challenging to spot in a young child, as it can appear intermittently and therefore is not always noticeable. In fact, crossed eyes can be quite common in infants, but this is usually a normal part of visual development and doesn’t always indicate strabismus. It can sometimes also switch from eye to eye, though most cases are unilateral.


For these reasons, the best way to detect strabismus is by taking your child for a routine eye examination. Strabismus is not something children can outgrow, so the earlier it can be diagnosed and treated, the better your child’s chances of aligning the eyes and having normal vision.


There are several types of strabismus; some can be treated without surgery. For example, ‘accommodative esotropia’ is when a child develops a turned eye to compensate for uncorrected far-sightedness, caused from the effort of trying to focus. This type can often be treated with prescription glasses.


But for most kinds of strabismus in children, surgery is the only treatment option. Surgery can also be effective for adults with strabismus, but it will not completely correct ‘lazy eye’, which is why early intervention is ideal. Sometimes more than one surgery is necessary to get the best possible outcome. Although surgery may sound scary, the recovery time is quick, and most children are able to go about their normal lives in just a few days.


It’s important to remember that correcting strabismus isn’t merely cosmetic. While the appearance of crossed eyes can often cause patients to feel self-conscious or unconfident, which the surgery will help with, it’s also a reconstructive procedure that can improve vision and depth perception, as well as prevent future problems that could develop from untreated strabismus.


Be sure to discuss all of your concerns with your eye care team, who can guide you through everything you need to know and provide support to you and your child throughout the whole process.

This article is written on behalf of Moorfields Eye Hospital in UAE.

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