Strabismus

Commonly affecting children and appearing in early childhood, strabismus is a common eye condition in which the eyes do not line up together. The condition is typically noticeable by looking at the eyes, and noticing that one eye is looking in another direction to the other eye.

Strabismus (also called crossed eyes, lazy eye, eye misalignment, or squint), will need a diagnosis by an ophthalmologist. If left untreated, the condition may lead to amblyopia (lazy eye), where vision may become stronger in one eye than the other.

While the condition is more common in children, it can occur in adults, due to certain conditions, injuries or illnesses that can affect the eye muscles.

Contact our team to book an eye assessment for you or your child at Valley Eye Specialists in Brisbane. Our experienced ophthalmologists can perform a variety of tests to assess eye health and correctly diagnose strabismus.

What is strabismus?

Strabismus is an eye condition characterised by a misalignment of the eyes. Strabismus may occur intermittently or persistently, and typically manifests in early childhood, (although, rarely, it can be present at birth).

In a person with strabismus, one eye may look straight ahead while the other eye turns inward, outward, upward, or downward.

There are different types of strabismus, depending on the direction in which the eyes are misaligned:

  • Esotropia, where one eye turns inward toward the nose.
  • Exotropia, where one eye turns outward toward the ear.
  • Hypertropia, where one eye turns upward.
  • Hypotropia, where one eye turns downward.
As well as the visible misalignment of the eyes, strabismus may lead to further vision concerns, such as amblyopia (lazy eye), where the brain favours one eye over the other, resulting in reduced vision in the weaker eye, if left untreated.
Strabismus in kids 01, Valley Eye

How can vision be affected by strabismus?

When the eyes do not align properly, they will send conflicting images to the brain.

To cope, the brain may disregard part of the input from one eye. Over time, the condition can lead to reduced vision in the strabismus eye, known as amblyopia.

Strabismus can sometimes impact a child’s depth perception and coordination, potentially causing difficulties with tasks like judging distance or hand-eye coordination.

What causes strabismus?

Strabismus, which affects about five out of every 100 children, results from the eyes’ inability to maintain proper alignment.

The condition can have a variety of causes, including concerns with the eye muscles or the brain’s visual area controlling eye alignment.

The six muscles attached to the white outer layer of each eyeball contract and relax, which controls how the eyes move. If a condition is affecting the way that these muscles are working together, it can cause strabismus. Typically, the condition is caused by a failure of the visual area of the brain that controls the alignment of the eyes.

Children with focusing issues, particularly those who are long-sighted, can be more likely to develop the condition. Other conditions that affect the eye muscles, or injuries and illnesses that weaken the muscles, can also lead to strabismus, however this is less common.

Symptoms of strabismus

Strabismus can usually be seen by noticing that one eye has turned in another direction to the other eye (misaligned eyes).

Other common signs of a strabismus eye can include:

  • Closing one eye
  • Clumsiness (or difficulty with hand-eye coordination)
  • An unusual head position (such as tilting)

Sometimes, the symptoms of strabismus may only become noticeable when the person is looking in a particular direction, or may be tired or unwell. For some children, the condition can go unnoticed until they are old enough to communicate the vision concerns they may be experiencing (such as blurry vision or difficulty reading).

Booking regular eye tests for your child can help to identify any potential eye conditions that may be hard to spot.

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Who is more likely to experience strabismus?

Strabismus can affect anyone, but certain factors may increase the likelihood of experiencing it.

Children, especially those with focusing issues like long-sightedness, are more prone to strabismus. The condition can also be present at birth, although this is rare.

Sometimes, although rare, conditions that affect the eye muscles or injuries and illnesses that weaken them can also contribute to the development of strabismus.

In adults, conditions that may cause strabismus include nerve damage, trauma (such as head injuries or damage to the eye muscles), thyroid eye disease (Graves’ disease), high refractive error, cataracts, neuromuscular disorders, diabetes and other health conditions. Strabismus caused by these conditions can be constant, or may only appear if the person is tired or looking in a certain direction.

Treating strabismus

The main objective for treating strabismus is to improve eye alignment and to restore normal vision, or prevent vision concerns from developing later on.

The treatment for the condition will depend on the cause, which our ophthalmologists can help to find. At Valley Eye Specialists, we offer comprehensive care for strabismus, integrating the Queensland Paediatric Ophthalmology and Strabismus Surgeons (QPOSS). Our collaborative approach assists in identifying and treating strabismus in children, creating tailored and effective management strategies for each patient.

Treatment for strabismus can include wearing full-time glasses, wearing an eye patch (for some of the time), surgery to help straighten the eyes, or surgery to remove the cause of the turn (for example, cataract removal surgery).

Testing for strabismus

Up until about four months of age, it’s common for a baby’s eyes to occasionally appear misaligned. However, persistent or increasingly noticeable strabismus is not normal, and may indicate underlying eye or health issues.

The early assessment, diagnosis, and treatment of any possible eye or health conditions are essential early in the child’s life.
Ophthalmologists can perform a variety of tests to examine if a child’s eyes are properly aligned. A comprehensive examination of the internal eye, often involving pupil dilation with drops, will also be needed to conduct the test. Sometimes, an extended eyepatch test may also be required for further evaluation.

Testing for strabismus can include:

  • An examination of the internal eye
  • Pupil dilation with drops
  • An extended eyepatch test
  • A depth perception test
  • A head-tilt test
Strabismus - 1

Depending on you or your child’s needs, a variety of tests may be conducted to help accurately diagnose the condition, and help to find the cause. A thorough examination and an accurate diagnosis will help to form the right treatment plan for you.

To test for strabismus (also called crossed eyes, eye misalignment, lazy eye, or squint), book a consultation with one of our ophthalmologists at Brisbane’s Valley Eye Specialists.

FAQs

Strabismus is quite common, as it affects approximately five in every 100 children. The condition can also occur in adults, although it is less common.
Adults can develop the condition, however, it is not as common. The condition is more commonly seen in children. Strabismus in adults can occur due to a variety of causes, such as trauma or injuries, health conditions, illnesses or muscle-related concerns. Conditions that affect the muscles responsible for eye movement may cause the condition.
If strabismus is left untreated, it can lead to a condition called amblyopia or “lazy eye,” where the brain favours one eye over the other, resulting in reduced vision in the weaker eye. Early treatment can help to prevent this condition and protect eyesight.

Strabismus should be treated as early as possible – especially if it is persistent, or becoming more noticeable. Early intervention can help to prevent vision loss and correct alignment issues. We recommend scheduling frequent eye examinations for your children, as some eye health conditions may go unnoticed at an early age.

Treatment for strabismus can include non-surgical methods, such as wearing glasses full-time or wearing an eye patch for some of the time. However, for more significant cases, or when non-surgical treatments have not worked, eye surgery may be necessary. When you come into our clinic for an eye test, our ophthalmologists can discuss your treatment options and create a treatment plan that suits your needs.
With early diagnosis and treatment, many cases of strabismus can be effectively treated and managed, helping to maintain good eye alignment and vision. However, long-term follow-up may be necessary to monitor eye health, and to prevent the recurrence of the condition.