Crossed eyes; Esotropia; Exotropia; Hypotropia; Hypertropia; Squint; Walleye; Misalignment of the eyes; Comitant strabismus; Noncomitant strabismus
The first step in treating strabismus is to prescribe glasses, if needed.
Amblyopia or lazy eye must be treated first. A patch is placed over the better eye. This forces the weaker eye to work harder.
Your child may not like wearing a patch or eyeglasses. A patch forces the child to see through the weaker eye at first. However, it is very important to use the patch or eyeglasses as directed.
If the eyes still do not move correctly, eye muscle surgery may be needed. Different muscles in the eye will be made stronger or weaker.
Eye muscle repair surgery does not fix the poor vision of a lazy eye. A child may have to wear glasses after surgery. In general, the younger a child is when the surgery is done, the better the result.
Adults with mild strabismus that comes and goes may do well with glasses and eye muscle exercises to help keep the eyes straight. More severe forms of adult strabismus will need surgery to straighten the eyes. If strabismus has occurred because of vision loss, the vision loss will need to be corrected before strabismus surgery can be successful.
After surgery, the eyes may look straight but vision problems can remain.
The child may still have reading problems in school, and for adults driving may be more difficult. Vision may affect the ability to play sports.
With early diagnosis and treatment, the problem can usually be corrected. Delayed treatment may lead to permanent vision loss in one eye. About one-third of children with strabismus will develop amblyopia.
Because many children will get strabismus or amblyopia again, they need to be monitored closely.
Strabismus requires prompt medical evaluation. Call for an appointment with your health care provider or eye doctor if your child:
Note: Learning difficulties or problems at school can sometimes be due to a child's inability to see the blackboard or reading material.
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Goldstein HP, Scott AB. Ocular motility. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 23.
Parks MM. Binocular vision adaptations in strabismus. Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 8.
Baloh RW. Neuro-ophthalmology. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 450.
Olitsky SE, Hug D, Smith LP. Disorders of eye movement and alignment. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 622.
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