Strabismus

Strabismus is a condition in which the eyes are not aligned and may point in different directions. It often begins in childhood but can also develop in adults. Misalignment may be constant or intermittent and can affect appearance, binocular vision, depth perception and, particularly in children, visual development.

Treatment depends on the type and cause of the strabismus. Options may include prescription glasses, prism lenses, treatment for amblyopia, selected orthoptic exercises and eye-muscle surgery. Glasses can correct refractive errors that contribute to misalignment, while prisms may help reduce double vision in certain patients. Eye exercises are useful for specific conditions, such as some convergence disorders, but are not appropriate for every type of strabismus.

Strabismus surgery adjusts the position or tension of one or more eye muscles to improve alignment. Surgery may be performed in both children and adults, but the treatment plan and expected outcome depend on the type of strabismus, age, visual function and previous treatment. Some patients may require more than one procedure or continued use of glasses after surgery.

In children, untreated strabismus may be associated with amblyopia, commonly known as lazy eye. Amblyopia develops when the brain favours one eye and visual development in the other eye is reduced. Treatment is most effective during childhood, so early assessment is important. Amblyopia treatment may include glasses, patching or other methods in addition to treatment of the eye alignment.

Children with persistent or intermittent eye misalignment should be examined by an ophthalmologist. Adults who develop sudden strabismus or double vision should also seek prompt medical assessment, as new eye misalignment can occasionally be related to neurological or other underlying medical conditions.