Strabismus

Strabismus is a misalignment in the eyes that affects vision and can cause amblyopia.

Strabismus is a vision condition in which the eyes are not properly aligned with each other. The misalignment can be present full time or occur intermittently when tired or focusing on near or distant targets. Strabismus occurs in about four percent of children in the United States.

What causes strabismus?

In many children, the cause is not clear. Some people may be born with a natural misalignment in their eyes, known as congenital strabismus. Strabismus also can be caused by a high or uneven refractive error – the term used to describe a child’s eye that is optically out of focus due to nearsightedness, farsightedness or astigmatism. Since it can sometimes occur when one eye has a serious anatomical condition, such as a cataract or a retinal disorder, all children with strabismus should have a complete eye exam.

The eyes can be misaligned in any direction, and the direction determines the specific type of strabismus:

• Esotropia: The eyes turn in or cross
• Exotropia: The eyes drift apart or out
• Hypertropia: One eye drifts up
• Hypotropia: One eye drifts down

What are the symptoms of strabismus?

Symptoms may include:

• Eyes that do not look in the same direction
• Uncoordinated eyes that don’t move together
• Poor depth perception (bumping into things)
• Vision loss
• Double vision
• Squinting, tilting the head or closing one eye to see

How do you treat strabismus?

Treatment may include eyeglasses or surgery to correct the unbalanced eye muscles and straighten the eyes. It is important to remember that strabismus also may cause amblyopia (loss or lack of full development of vision in one eye), and therefore children with strabismus must often do eye patch therapy.

Your Henry Ford pediatric ophthalmologist will recommend the best treatment based on your child’s unique needs, and work with you every step of the way.

Adult strabismus

Adults also may occasionally experience symptoms or problems related to strabismus:

• In most cases the adult strabismus had its onset in childhood
• Some patients will experience intermittent diplopia (double vision) or note a worsening misalignment of their eyes
• Potential treatment options for adult strabismus might include a prism incorporated into their glasses or strabismus surgery that may include the use of adjustable sutures
• Amblyopia associated with untreated strabismus from childhood cannot be improved in adulthood

Some adults may develop a new onset strabismus, usually associated with double vision that may improve or worsen when looking in different directions. This special form of adult strabismus may be the result of a head injury, tumor, stroke, diabetes or thyroid disease. It is important to find and treat the cause of this type of adult strabismus, which may involve evaluation and testing by other medical specialists. Eye treatment sometimes involves the use of a prism in glasses or temporarily covering one eye to eliminate double vision. If no improvement is seen after a period of observation, strabismus surgery may be required.

At Henry Ford, patients come first.

The Henry Ford Department of Ophthalmology is committed to providing our patients with compassionate, personalized care. We feature the most advanced treatments in eye care and are dedicated to vision research – always staying at the forefront of innovation. A leader in Michigan, as well as one of the largest ophthalmology practices in the United States, we treat more than 55,000 patients per year at 12 locations throughout southeast Michigan. In addition, our team works closely with Henry Ford Medical Group physicians in other departments, providing multidisciplinary, coordinated care for those patients who need it.