Strabismus – Strabismus: Causes, Symptoms, Types, Diagnosis, Associated Conditions and Treatment

It is a defect in vision that affects the ability of the eye to coordinate movements when focusing on objects.

Offering two asymmetric views, imperfectly aligned eyes often cause defective depth perception and are associated with disorders such as crossed eyes, strabismus, walleye, and heterotopia.

Without proper treatment of strabismus, these conditions may worsen, and specific aspects of vision may be permanently affected.

The term strabismus refers to a person suffering from strabismus.

Causes of strabismus

Strabismus differs from refractive errors, such as myopia, hyperopia, and astigmatism. In some cases, the inability of the eyes to focus symmetrically can be attributed to problems with the muscles that control eye movement.

More commonly, however, strabismus results from problems in the brain. The brain may have difficulties fusing the two images it receives from the eyes, and, in rare cases, a tumor may be affecting its ability to process visual information.

Children often experience strabismus due to problems that can easily be treated with glasses. There is also evidence that the condition can be hereditary.



The different types of strabismus produce a variety of symptoms.

Depending on the eye’s orientation or the misaligned eyes, people suffering from this disorder may have difficulty concentrating on objects or judging distances; they may also experience double or blurred vision.

Detecting symptoms is the first step to determining if surgery is advisable as strabismus treatment.

Perhaps the most prominent symptom is a crossed eye or a single eye that leans visibly to the left, right, up, or down and can not coordinate movements with its partner. Squinting in children can also be a sign of this condition.


Strabismus can take several different forms depending on how the vision is interrupted. The best treatment plan for strabismus can be determined once the doctors have accurately diagnosed what form is involved.

If the affected eye or eyes always show an inability to coordinate movements properly, constant strabismus is known. If the problems only occur episodically, it is considered intermittent.

Another disorder, esotropia, occurs when both eyes are turned inward, resulting in crossed eyes.

The disorder is known as exotropia if the eyes’ turn is oriented outward instead of inward.

Children who experience this condition often daydream or do not pay attention. Another type of strabismus is hypertropia, in which symmetric vision is inhibited by the excessive upward orientation of one or both eyes.

Finally, a complicated condition known as Duane syndrome affects the ability of the eye to perform regular lateral movements to and from the nose.

Here, the problem is not that an eye is abnormally tilted but that it does not turn enough when the gaze moves to the right or the left.


The diagnosis of strabismus should occur as soon as possible and, of course, before a child reaches the age of two.

All children should receive a checkup between six and nine months, ideally never more than one year.

Strabismus treatment becomes problematic when the child is more than two years old, and even strabismus surgery is often ineffective.

In addition to carefully looking for visible signs such as unruly, crossed, or divergent eyes, doctors will consider a child’s medical history when determining if an eye disease, uncorrected vision, or other condition is causing symptoms.

Conditions associated with strabismus

One strabismus results are double vision, which occurs when two uncoordinated eyes do not focus on the same object.

As a result of this inability, two separate and slightly out-of-series views of the world are transmitted to the brain, which makes patients see everything twice.

However, while double vision is often caused directly by strabismus, it may have other origins. Therefore, its presence does not necessarily require strabismus treatment.

Likewise, many symptoms that initially suggest the presence of this condition, such as divergent, misaligned, or converging eyes, may also indicate unrelated conditions that require their particular course of treatment.

Any comprehensive diagnosis will involve ruling out conditions often mistaken for strabismus, including amblyopia (lazy eye), cataracts, exophoria, and Graves’ disease.


The treatment of strabismus ranges from being as simple as correcting the sight of children with glasses and relatively simple vision therapy to more complex strabismus surgery.

Intermittent strabismus, for example, can usually be treated effectively with eye patches, special glasses, and visual therapy.

Over time, such essential treatment usually allows the brain to control eye movements, and surgery is not required.

In cases of constant strabismus, the surgical option can be recommended. However, since there is no guarantee that it improves vision, this is generally considered a last resort.