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 specialist.

"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," Keech says.

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 develop amblyopia."

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 perception.

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 provider.