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What You Should Know: Strabismus

about strabismus

Strabismus, the medical term for any eye misalignment, is a condition that can affect both children and adults. This month, we’re highlighting strabismus and educating our community on the eye disease and what it can mean for you and your family. Read on for more insights and takeaways of what you should know about strabismus... 


What is Strabismus?  

While the natural eye position is to be aligned in the same direction, Strabismus is any type of misalignment of the eye. It is estimated that 4% of the U.S. population has strabismus. It is also more commonly found in children, but can also occur in adults.  

Strabismus is described by the direction of the misaligned eye. These positions include:  

- Inward crossing (esotropia) 

- Outwards (exotropia) 

- Upward (hypertropia) 

- Downward (hypotropia) 

Esotropia (inward crossing) is the most common horizontal strabismus in children and is divided into many different types. The two most common occurring in childhood are:  

- Infantile esotropia: Onset occurs by 6 months of age with a large amount of crossing and is constant. 

- Accommodative esotropia: Onset occurs later, around 2-3 years old, and is due to high far-sightedness (hyperopia). This type of crossing is usually treated with glasses. 


What are the Symptoms?  

The most common and noticeable symptom is obviously some type of ocular misalignment. Other symptoms are more frequent in older children. These can include:  

- Blurry vision 

- Eye strain 

- Fatigue 

- Headaches  

- Head tilt or abnormal head position 

- Double vision 

- Abnormal 3-D vision 

It is important to be aware of these symptoms and assess them both in yourself and your children. We often hear the term “Lazy Eye” as a symptom as well, and there is a distinction to be made with this term. Lazy eye is a non-specific, non-medical description that can be used to describe any problem with eyes or vision development. The term is most often used to describe strabismus (misalignment), amblyopia (poor vision), or ptosis (droopy eyelid).  


What Causes Strabismus?  

Strabismus is most commonly caused by a problem with the brain control of eye alignment and movement. Less commonly, it is a problem with the muscle or eye itself. It is not completely understood, however there is a genetic component and can run in families. Other causes, of the many, include:  

- Refractive error (near-sighted, far-sighted, astigmatism) 

- Amblyopia (poor vision development) 

- Cataract 

- Retinopathy or prematurity 

- Genetic medical conditions associated with strabismus 

- Trauma 

- Neurologic  


How is Strabismus Treated?  

An ophthalmologist specially trained in strabismus will determine the appropriate treatment plan based on the type and cause of the misalignment. Not all strabismus is the same, so they are not all treated the same, even if multiple family members are diagnosed. Treatment options may include a combination of the following:  

- Glasses  

- Eye patching 

- Surgery 

- Observation  

- Exercises  

- Prisms 

- Treatment of underlying disease or medical problem  


In all cases, close monitoring of vision development in childhood is vital in children with strabismus to ensure continued vision development. At ReFocus Eye Health, we have trained experts who can conduct comprehensive eye exams for your family, and then develop a customized treatment plan for any patients with strabismus. Especially with school beginning again, it is critical to have eye exams completed and ensure children are on the right path for optimal learning success. Contact us today to schedule an appointment.