Your eyes are members of a three-part team. In addition to your eyes, the optical nerve and the brain are the second and third members of the visual “three musketeers.”
When the eyes and the brain are not able to work together, which is the case when a child has crossed eyes (strabismus), it causes vision problems. Waiting too long to correct crossed eyes can lead to permanent vision loss and also makes it more difficult to treat down the road.
What Is Strabismus (Crossed Eyes)?
Strabismus is a condition where the eyes look in different directions at the same time. Almost all newborns can appear slightly cross eyed because it takes a bit of practice and focus for the eyes to get coordinated. By the time infants’ faces grow a bit bigger and they get better at focusing on the world around them, this “fake crossed eyes” fades away. However, some children develop crossed eyes in their first few years of life, and certain conditions can occasionally cause strabismus in older children or adults.
There are six different muscles that allow the eyeballs to move around in the eye socket and focus where they need to. Depending on which muscle is weakened, crossed eyes may rotate up, down, or to either side, but not together. People may be able to focus their eyes at the same time on an object in front of them or to read, but then one or the other eye may roll to the weak spot when they are feeling tired, ill, or spending extra reading.
While strabismus not the same condition as a lazy eye (amblyopia), the results can be the same. Without early detection and treatment, the brain will simply stop receiving messages from the weakest of the eyes, and that connection may never be regained. That puts patients at risk for permanent vision loss.
Symptoms Of Crossed Eyes
The most notable symptom is part of the condition’s name; you’ll notice one or both eyes rolling off into a “crossed” position or in completely different directions. This can be seen by anyone looking at the individual with crossed eyes.
Children with crossed eyes may not notice their eyes are crossing. In that case, symptoms include:
- Frequent blinking or squinting
- Light sensitivity
- Headaches or eye strain
- Needing to tilt the head to look at things
- Trouble with depth perception (misstepping, misjudging curbs or stairs, difficult catching/hitting/kicking a ball in sports)
Your pediatric and annual eye exams are the first step in getting an accurate diagnosis of crossed eyes and creating a treatment plan.
Parents are more likely to have a child with crossed eyes or to develop them, if:
- There is a family history of strabismus
- You’ve had a traumatic head injury
- A child is born with cerebral palsy, downs syndrome, and other chromosomal/genetic defects that affect the neural pathways
- The child has severe farsightedness (hyperopia)
Types Of Strabismus
If your optometrist determines your child has strabismus, s/he’ll tell you the classification, which is based on the direction the eye turns and other facts about how the eyes move separately from one another. The AOA’s criteria state strabismus classification is as follows:
“Strabismus is classified by the direction the eye turns:
- Esotropia: inward turning.
- Exotropia: outward turning.
- Hypertropia: upward turning.
- Hypotropia: downward turning.
Other classifications of strabismus include:
- The frequency with which it occurs (either constant or intermittent).
- Whether it always involves the same eye (unilateral).
- If the turning eye is sometimes the right eye and other times the left eye (alternating).”
Once the type and severity of the condition are determined, we’ll work with you to create a treatment plan.
Common Methods For Treating Crossed Eyes
In most cases, strabismus is treated one of four ways:
Eyeglasses and contact lenses
This helps to correct vision impairment and maybe the only treatment required for certain patients. Once their eyes are able to focus with the eyeglasses and/or contacts, the muscles regain their strength and routine vision checks keep your prescription lenses up to date.
Prism lenses are specialty glasses that are made with one side thicker than the other. This changes how the light enters the eye. When the light is adjusted appropriately, it alternates how the eye moves to focus on objects and that can notably minimize or eliminate eye turning.
Eye exercises for crossed eyes
Even the eyes have to do physical therapy sometimes, and so there are particular exercises we have patients do to strengthen the eye muscles and to strengthen and enhance the communication between “the visual three musketeers” (eyes, optical nerve, and the brain). Your optometrist will assign specific eye exercises depending on your diagnosis, and s/he’ll explain how – and how often – to do them.
Surgical repair of the eye muscles
Remember we mentioned there are six different muscles that control the eye’s motion/direction in the socket? In some cases, muscular issues can be repaired surgically by an ophthalmologist. Once the surgery is complete, the patient will probably still need to do eye exercises to re-coordinate and strengthen the eye muscles so they are realigned again. Glasses or contacts may also be necessary.
While there is no way to prevent crossed eyes, your swift attention and treatment are essential for preventing long-term complications that result from the condition. This is one of the reasons why babies and young children should always be screened by your pediatrician or optometrist at least once before they are six months of age, and then again by an optometrist between the ages of three and five years old.
Read our post How Often Should You Get an Eye Exam to help you create age- and condition-specific vision care calendar reminders for each member of your family.
Call To Schedule An Exam
Are you concerned that a member of your family has crossed eyes? Schedule a visit with us here at Atlantic Eye Institute where a team of family-friendly and highly experienced optometrists and ophthalmologists are waiting to help you keep the world in better focus.