Strabismus, sometimes referred to as “crossed eyes,” is a condition where a patient’s eyes do not align to look at objects. While one eye focuses, the other deviates and looks in another direction. This problem can affect one eye or shift between eyes. Some patients experience strabismus all the time, while others only notice it on occasion.
About one in 25 children under the age of 6 is diagnosed with strabismus. If left untreated, the weaker eye can lose its capacity to communicate with the brain, which can cause lasting vision loss or impairment. When the eyes do not both look at that same object at the same time, they are also unable to cooperate with each other, which causes difficulties with depth perception. Finally, individuals with strabismus often feel like they are unable to make good eye contact with others. This can make them feel self-conscious in social situations and diminish their confidence.
Dr. Carolyn Graeber is an ophthalmologist who specializes in the treatment of strabismus. Throughout her career, she has helped children and adults to realign their eyes for improved vision, depth perception, and eye contact.
In children, the exact cause of strabismus is often unknown, though it is sometimes associated with vision loss, certain medical conditions, prematurity, or family history of strabismus. Common symptoms of strabismus include reading intolerance or discomfort, double vision, or a loss of depth perception. Most children, however, will not report any symptoms. Usually a family member, teacher, physician, or other individual notices that the eyes are not moving well together or that the child is having difficulties with tracking. Any of the above signs should prompt evaluation with a specialist like Dr. Graeber.
Parents should be aware that many newborn babies will have occasional eye misalignment during the first few months of life. This is very common and is not worrisome unless the eyes are never straight. However, by the time babies are four months old, their eyes should be able to focus in unison all the time. Children older than a few months who continue to have eyes that are not straight should undergo a comprehensive eye examination.
Dr. Graeber examines all individuals from newborns to adults to diagnose strabismus and determine the appropriate treatment plan. She conducts age-appropriate assessments designed to measure eye alignment, focusing abilities and visual acuity.
Strabismus in Adults
Although strabismus is most common in children, it can also occur in adults. For many adult patients, strabismus has either recurred or was never corrected in childhood. Others only start to notice symptoms after another medical condition like diabetes, stroke, thyroid eye disease or a tumor cause the eye alignment to change.
In adults, double vision, unusual eye movements, or new eye misalignments should always be evaluated by a specialist. Advanced testing is often required to determine the underlying cause, make the diagnosis, and treat the condition.
Dr. Graeber trained at one of the premier institutions for adult strabismus in the United States and routinely uses advanced techniques like Botox and adjustable sutures to help correct eye alignment in adults.
Strabismus can be a sign of a significant eye or other medical problem, and it is important that it is evaluated by a specialist to determine if there is an underlying cause and if treatment is needed. Dr. Graeber encourages parents to seek evaluation of strabismus on behalf of their children as soon as possible to avoid long-term visual impairment. Strabismus treatment options include:
For some patients, prescription lenses are sufficient to correct strabismus, and glasses are often the mainstay of treatment. In adults with double vision, prisms can sometimes reduce or eliminate double vision.
Patching is often a key feature in the treatment of strabismus. A patch is placed over the straight eye to help improve the alignment of the deviating eye. Depending on the severity of the condition, patching may be recommended for a short time or for much longer.
In some instances, patients can find relief from symptoms by doing exercises for their eye muscles. By engaging in a deliberate course of eye focusing and coordination exercises, the brain and eyes learn to work more harmoniously.
Many years ago, botulinum toxin A, commonly known as Botox, was found to relax muscles. Injection of Botox can help to restore the balance of the eye muscles and correct strabismus. This approach can be done in Dr. Graeber’s office for older individuals or in the operating room for younger patients.
While other approaches are often tried first, sometimes surgery is the best option to correct eye alignment. During surgery, a small incision is made in the conjunctiva (the clear skin covering the eye) to access the eye muscles. Designated muscles are then repositioned and either tightened or loosened to put the eyes in better alignment.
Schedule an Appointment
You may be understandably concerned if you or your child develops crossed eyes, but the good news is the condition can be treated. To schedule an appointment with a strabismus expert who can work with you or your child toward proper eye alignment, please call 970-214-8175.