Crossed Eyes (Strabismus): Symptoms, Causes, and Diagnosis (2024)

What are crossed eyes?

Crossed eyes, also called strabismus, is a condition in which your eyes don’t line up. If you have this condition, your eyes look in different directions. And each eye will focus on a different object.

The condition is more common in children, but it can also occur later in life. In older children and adults, crossed eyes can be caused by a variety of underlying medical conditions, like cerebral palsy or stroke.

Crossed eyes can usually be corrected with corrective lenses, surgery, or a combination of both.

If you have crossed eyes, your eyes might point inward or outward or focus in different directions. You might also have:

  • impaired vision
  • double vision
  • decreased depth perception
  • eyestrain or headache

Your symptoms may be constant or appear only when you’re tired or not feeling well.

Crossed eyes occur either due to nerve damage or when the muscles around your eyes don’t work together because some are weaker than others. When your brain receives a different visual message from each eye, it ignores the signals coming from your weaker eye.

If your condition isn’t corrected, you may lose vision in your weaker eye.

Crossed eyes are common in children. Often the underlying cause is unknown. Infantile esotropia is a type of crossed eyes that appears in babies during their first year of life.

Esotropia runs in families and usually requires surgery to correct. Acquired esotropia occurs in children usually between the ages of 2 and 5. Eyeglasses can usually correct it.

Crossed eyes can also occur later in life. It’s usually caused by physical disorders, like eye injuries, cerebral palsy, or stroke. You may also develop crossed eyes if you have a lazy eye or are farsighted.

To prevent vision loss, early diagnosis and treatment for crossed eyes is important. If you develop symptoms of crossed eyes, make an appointment with an eye doctor. They’ll perform a series of tests to check the health of your eyes that may include:

  • a corneal light reflex test to check for crossed eyes
  • a visual acuity test to determine how well you can read from a distance
  • a cover/uncover test to measure your eye movement and deviation
  • a retina exam to examine the backs of your eyes

If you have other physical symptoms along with crossed eyes, your doctor may examine your brain and nervous system for other conditions. For example, they may conduct tests to check for cerebral palsy or Guillain-Barré syndrome.

It’s common for newborn babies to have crossed eyes. If your baby has crossed eyes that persist beyond 3 months of age, make an appointment with their doctor. Young children should undergo an eye exam before 3 years of age.

You’re more likely to develop crossed eyes if you:

  • have family members who have crossed eyes
  • have a brain disorder or brain tumor
  • have had a stroke or brain injury
  • have a lazy eye, are farsighted, or have vision loss
  • have a damaged retina
  • have diabetes

Your recommended treatment plan for crossed eyes will depend on the severity and underlying cause of your condition. If your crossed eyes have resulted from a lazy eye, your doctor may have you wear a patch over your stronger eye to force the muscles of your weaker eye to work harder.

Your doctor might also prescribe eye drops to blur the vision in your stronger eye. They can also use Botox injections to weaken the muscle that’s overacting and causing the eye turn.

Other potential treatments include:

  • eye exercises
  • corrective lenses, such as eyeglasses or contact lenses
  • surgery on certain eye muscles, particularly if corrective lenses haven’t corrected the condition

If your crossed eyes are caused by an underlying medical condition, such as a brain tumor or stroke, your doctor may prescribe medication, surgery, or other treatments.

Often crossed eyes can be corrected with corrective lenses, eye patches, surgery in rare cases, or by other modalities.

It’s important to seek treatment right away to lower your risk for vision loss. After you’ve received treatment, watch your eyes for changes. In some cases, the condition may come back.

If your crossed eyes are caused by an underlying medical condition, early diagnosis and treatment may help improve your chances of recovery.

Ask your doctor for more information about your specific condition and treatment options.

Crossed Eyes (Strabismus): Symptoms, Causes, and Diagnosis (2024)

FAQs

Crossed Eyes (Strabismus): Symptoms, Causes, and Diagnosis? ›

Crossed eyes, or strabismus, is a condition in which both eyes do not look at the same place at the same time. It usually occurs in people who have poor eye muscle control or are very farsighted. Six muscles attach to each eye to control how it moves.

What causes strabismus or crossed eyes? ›

Crossed eyes, or strabismus, is a condition in which both eyes do not look at the same place at the same time. It usually occurs in people who have poor eye muscle control or are very farsighted. Six muscles attach to each eye to control how it moves.

What is the diagnosis of strabismus? ›

How is strabismus diagnosed? A doctor can often tell that a child has strabismus just by looking at the child's eyes. It may be obvious that the eyes don't look in the same direction at the same time. The doctor may have the child look at an object while covering and then uncovering each eye.

Why did I suddenly go cross eyed? ›

What causes crossed eyes? Crossed eyes occur either due to nerve damage or when the muscles around your eyes don't work together because some are weaker than others. When your brain receives a different visual message from each eye, it ignores the signals coming from your weaker eye.

How do you fix strabismus? ›

The most common treatments for strabismus are:
  1. Glasses. Wearing glasses can sometimes correct mild strabismus.
  2. A temporary eye patch over the stronger eye if your child has amblyopia. This can make the weak eye stronger, which may help align the eyes. ...
  3. Surgery on the eye muscles.

What neurological disorder causes strabismus? ›

Risk factors for strabismus

Cerebral palsy. Down syndrome (20% to 60% of people with Down syndrome also have strabismus). Hydrocephalus (a disease that you're born with that results in a buildup of fluid in your brain). Brain tumors.

What causes sudden onset strabismus in adults? ›

Damage to different cranial nerves can cause strabismus and double vision,” Dr. Howard says. Strabismus can occur in people with a history of thyroid disease, even if the thyroid blood levels are in control. Tumors in the brain stem or in the eye can cause strabismus as can trauma.

What do people with strabismus see? ›

Adults who develop strabismus after childhood often have double vision. This is because their brains have already learned to receive images from both eyes. Their brains cannot ignore the image from the turned eye, so they see two images.

Can stress cause strabismus? ›

Examples of Intermittent Strabismus. Most cases of intermittent strabismus are horizontal - the eye turns out (exo) or in (eso). In many cases, the patient has a somewhat fragile binocular vision system, and additional stressors (such as extended near work, computer use, or homework) cause the eye to deviate.

Can you develop strabismus later in life? ›

Most adults with strabismus have had it since childhood, but others develop it later in life. Often, as the eye ages, the muscles don't function properly, or they weaken. For adults who've had strabismus as children, the condition can reappear.

What happens if you don't fix strabismus? ›

People who are born with strabismus will lose binocular vision if they aren't treated, or they will develop double vision.

Is cross-eyed a disability? ›

Having a squint is not usually considered a disability unless it significantly affects how you go about day to day life. Childhood strabismus that isn't treated can lead to a lazy eye, with vision loss in the affected eye. If your vision in the other eye is good, this is unlikely to cause a disability.

Does strabismus ever go away? ›

Strabismus usually can be fixed when found and treated early. If it's not treated, the brain eventually will ignore the visual images of the weaker eye. This change — called amblyopia, or "lazy eye" — can make vision blurry, cause double vision, and harm a child's depth perception (seeing in 3D).

Is strabismus caused by inbreeding? ›

Parents of patients with strabismus had higher incidence of first cousin marriage compared to control group (χ2 = 28.5, df = 1, p < 0.001). Patients with strabismus had higher mean inbreeding coefficient (α) compared to control group (T = 5.27, df = 880, P < 0.001).

What is the genetic cause of strabismus? ›

It has long been recognized that strabismus runs in families, and population, family, and twin studies all support a genetic contribution, but inheritance patterns are complex, and no definitive causative genes have been identified (14–20).

What is strabismus linked to? ›

In strabismus or squint, 1 or both eyes deviate inwards or outwards and appear to be in nonalignment towards the direction of the focused object (see Image. Strabismus). It can be due to refractive error, binocular fusion abnormalities, or neuromuscular anomalies of ocular movements.

Is strabismus something to worry about? ›

However, a child with any form of strabismus should be seen as soon as possible by an eye specialist to rule out vision loss or a visually dangerous or unexpected cause of the deviation. Sometimes esotropia isn't present from birth. A child's eyes might be fine up to age 3 or 4 years but then suddenly start to cross.

References

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