University of Iowa Health Science Relations and
Ronald Keech, MD
Professor of Ophthalmology & Visual Science
First Published: November 2000
Last Revised: March 2004
Peer Review Status: Internally Peer Reviewed
Angie noticed that one of her 3-month-old baby's eyes turned
inward. The baby's pediatrician recommended a visit to an eye care
"Angie's baby may have a form of strabismus, which means
misalignment of the eyes," says Dr. Ronald Keech, professor
of ophthalmology at the University of Iowa College of Medicine and
staff physician at UI Hospitals and Clinics. "It's common for a
baby's eyes to sometimes appear misaligned or crossed at birth. But
at 3 to 4 months, the baby's eyes should be well aligned, looking in
the same direction and focused on one object."
In the most common form of the condition, one or both eyes turn
inward. Exotropia, when the eye turns outward, is a less common form.
"Strabismus affects as many as one of every 50 school-age children,"
If not treated early, strabismus may cause loss of depth
perception, or more importantly, lazy eye. "Lazy eye, also called
amblyopia, is the loss of sight in one or both eyes from lack of
use," Keech says. "A large percentage of children with strabismus
Strabismus might also be a sign of an underlying problem,
including a tumor in the eye. "This is rare, but a child with
strabismus should be seen by an eye care provider," Keech says.
Although the cause of strabismus is not known, the condition runs in
families and occurs more commonly in children with neurological
problems, such as cerebral palsy. "Early detection and early
treatment are the keys to correcting strabismus and preventing the
development of permanent vision problems," Keech says. "It's very
important that the child is treated as young as possible because the
visual system is still responsive to treatment. With early treatment,
a child has a good change of normal vision with good depth
Lazy eye is commonly treated by placing a patch over the good eye
to force the lazy eye to focus, Keech says. Strabismus is most often
corrected with eyeglasses or surgery.
Strabismus is less common in adults. Causes of strabismus in
adults include prior strabismus as a child,head injury, thyroid
disease, or neurological disorders, Keech says. "Many adults with strabismus experience double vision or other
visual symptoms. Adult strabismus can usually be improved or
corrected with medication, glasses, or surgery, depending on the
causes," he adds.
If you have questions about strabismus, talk to your eye care