Understanding Strabismus (Crossed Eyes) - Symptoms, Causes, Risks, Diagnosis & Treatment

Understanding Strabismus (Crossed Eyes)

Strabismus, commonly referred to as crossed eyes, is a condition in which the eyes do not properly align with each other when looking at an object. One eye may turn inwards, outwards, upwards or downwards while the other eye looks straight ahead. This results in the eyes pointing in different directions and not focusing on the same spot simultaneously.

Symptoms of Strabismus

The main symptom of strabismus or crossed eyes is the inability of the eyes to work together at the same time. One of the most obvious signs is when one eye appears to be looking straight ahead while the other eye turns in a different direction. This causes double vision or in medical terms, diplopia. Images appear to be side by side or overlapping each other.

Other symptoms of strabismus may include:

• Headaches and eyestrain
• Inability to judge distances accurately
• Squinting or closing one eye
• Tilting or turning the head to focus
• Loss of side vision or peripheral vision

Causes of Crossed Eyes

Strabismus often develops in infants and young children, most of the time due to problems with binocular vision development. The exact cause may be difficult to determine but here are some factors that contribute to crossed eyes:

1. Weak eye muscles – Imbalance in the muscles attached to the eyeball affects eye coordination
2. Farsightedness – Eyes crossed inward to help see nearby objects better
3. Nearsightedness – Eyes crossed outward when looking at distant objects
4. Congenital defects – Birth defects affect development of eyesight
5. Nervous system disorders – Conditions such as cerebral palsy can impact muscle control
6. Injury or trauma – Damage to eye nerves or muscles

Risks and Complications of Strabismus

While a crossed or misaligned eye may seem harmless, if left untreated, it can lead to amblyopia or lazy eye disorder. In this condition, the brain ignores signals from the weaker eye resulting in partial or complete vision loss.

The longer strabismus goes untreated, the higher the risk of amblyopia. The vision loss associated with amblyopia is permanent if not corrected early in life. Along with appearance concerns, it creates issues with depth perception and vision in general.

Some complications associated with crossed eyes include:

• Permanent vision problems
• Social and self-esteem issues
• Limited educational opportunities and career options later in life
• Inability to get a driving license

Diagnosing Strabismus

Doctors can detect crossed eyes in children through simple vision screening exams. If signs of strabismus are noticed, the child will be referred to a pediatric ophthalmologist or optometrist for a comprehensive eye exam.

To evaluate crossed eyes, special tests are conducted to check alignment of the eyes –

1. Cover-uncover test – One eye is covered at a time to test how the uncovered eye moves
2. Corneal light reflex test – A light shined into each pupil to check reflection points
3. Direct ophthalmoscopy – Use of handheld device to magnify interior of the eye
4. Photoscreening – Use camera to photograph patient’s eyes

These painless procedures can accurately identify issues with eye alignment and depth perception. The doctor then recommends appropriate intervention based on underlying cause and condition severity.

Treating Strabismus (Crossed Eyes)

The most effective and preferred treatment for strabismus is early intervention through non-surgical treatments. The key goals are -

• Improve eye alignment and coordination
• Regain single binocular vision
• Avoid lazy eye and permanent vision damage

The common treatment options for crossed eyes include –

Eyeglasses

Wearing prescribed glasses helps improve vision and prevent eyes from crossing inward or outward to compensate for vision problems. Glasses need to be worn all waking hours for best results.

Eye Patches

Covering the stronger eye encourages the weaker crossed eye to straighten out. Eye patches and blurring eye drops may be used along with other therapies.

Vision Therapy Exercises

Orthoptic training involves dedicated practice to improve eye movement control and coordination. These can retrain eye muscles to align properly within a few months. Examples are pencil push-ups, brock string exercises using colored beads and Marsden balls.

At home eye crossing exercises also supplement vision therapy. This includes visual motor skills development through sports like ball games. Eye-hand coordination improves along with alignment of eyes.

Prisms

Special magnifying Fresnel plastic prisms placed on glasses shift images to the eye. This helps establish uniform vision by aligning the visual axis of each eye.

Eye Muscle Surgery

Strabismus surgery on extraocular muscles is considered only when non-surgical methods provide no lasting benefits after 6 to 12 months. Surgery restores muscle balance so eyes can focus straight.

Based on which direction eyes cross - inward, outward, upward or downward, different muscles are shortened, tightened, loosened or repositioned. Though minimally invasive, it does require administration of general anesthesia.

Prevention of Strabismus

While some cases of crossed eyes may not be preventable, the risk can be minimized by –

• Timely newborn and preschool vision screenings
• Early intervention with non-surgical treatment
• Ensuring proper distance from screen during device use
• Regular eye exams and vision correction with glasses
• Treating illnesses associated with muscle control issues

Providing adequate eye care and maintaining healthy habits encourage proper development and coordination of eyes in growing children.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.