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Strabismus

A crossed eye or out-turned eye is referred to clinically as strabismus. It is a muscle condition in which your eyes are not properly aligned with each other, resulting in double vision or the suppression of the image from the affected eye. For a variety of reasons, one or both of your eyes may turn in, out, up or down.

Who is affected by strabismus?

Children under age six are most affected by strabismus, but it usually first appears between birth and age 21 months. It is estimated that five per cent of all children have some type or degree of strabismus. Although rare, strabismus can sometimes begin in adulthood; this is usually the result of a stroke, tumor or other vascular disease.

Will a child outgrow strabismus?

A child will not outgrow strabismus without treatment. In fact, the condition may simply become worse without treatment.

What are the effects of strabismus?

Children with strabismus may initially have double vision. This occurs because both eyes are not focusing on the same object. In an attempt to avoid double vision, the brain will eventually disregard the image from one eye. This is referred to as suppression. In time, the ignored eye will become unable to function normally and will become largely unused. This may result in the development of lazy eye (amblyopia).

Diagnosis

Parents may be the first to notice a slight wandering of one or both of a child’s eyes. A comprehensive eye examination is recommended at six months of age and then yearly after age three. The examination can determine if strabismus is present.

Treatment

Treatment for strabismus can include eyeglasses (single vision or bifocal), prisms, vision therapy, and in some cases, surgery. Strabismus can be corrected with excellent results if detected and treated early.

There are different types of strabismus. They can be described by the cause or by the way the eye turns.

The following terms describe strabismus by the positions of the eye:

• Hypertropia is when the eye turns upwards

• Hypotropia is when the eye turns downwards

• Esotropia is when the eye turns inwards

• Exotropia is when the eye turns outwards

An early diagnosis of strabismus will enable more effective treatment.

While treatment up to the age of 6 years is believed to be most effective, strabismus can be treated at any time.

Causes

Coordination of your eyes and their ability to work together as a team develops in your first six to eight years. Failure of your eyes, or more precisely, your eye muscles, to work together properly can lead to strabismus. It has a tendency to be hereditary, but may also be acquired secondary to an eye injury or disease.

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