The two most common types of strabismus include accommodative esotropia and intermittent exotropia. The former occurs with farsightedness due to extra focusing that causes the eyes to turn inward, and the latter is an inability to coordinate both eyes together
Strabismus is an eye condition that causes the eyes to misalign and cross or wander. The eyes appear not to be looking at the same place at the same time.
The condition may present itself constantly or only during certain times, such as when the person is tired, ill, or doing tasks such as reading. It may always affect the same eye, both, or alternate. It is thought to be related to a high level of farsightedness.
There are six muscles that attach to and control each eye. They receive signals from the brain that direct the eye's movements. A person with poor eye-muscle control may develop strabismus. If this happens, the brain gets two different images and, over time, will learn to ignore the weaker eye. If left untreated, strabismus can lead to a permanent reduction in vision known as amblyopia, or lazy eye.
Some infants' eyes appear to be misaligned but are actually normal and just have skin covering the inner eye's corner; this may also appear in children with wide bridges of the nose. This is not serious and is called pseudostrabismus, or false strabismus. If a child is older than four months old and their eyes still are not straight, then it's time to see a doctor.
Strabismus is classified in three ways: the direction the eyes turn, frequency (constant or intermittent), and if it's the same eye (unilateral) or different eye (alternating). Below are the various directions an eye can turn and their respective names.
Esotropia is when one or both eyes turn inward.
Exotropia is when one or both eyes turn outward.
Hypotropia is when one or both eyes turn downward.
Hypertropia is when one or both eyes look upward.
The two most common types of strabismus include accommodative esotropia and intermittent exotropia. The former occurs with farsightedness due to extra focusing that causes the eyes to turn inward, and the latter is an inability to coordinate both eyes together, causing them to point beyond the object viewed.
Those with accommodative esotropia complain of double vision, will tilt or turn their head to see better, and close or cover one eye when looking at things close up.
Those with intermittent exotropia may develop headaches, have difficulty reading and eye strain, or close one eye when viewing objects at a distance or in bright light.
It is important to have tests performed if strabismus is suspected, especially if the person affected is a child. Typically, strabismus appears by age three but can happen later in life as well. Visual maturation happens by age eight, so it's important to be treated as early as possible because, unlike some conditions, strabismus cannot be outgrown and will get progressively worse.
The earlier strabismus is diagnosed and treated, the more likely it is to be corrected; however, some teenagers and adults have had luck alleviating the condition later in life as well.
Diagnosing Strabismus
There are several tests to determine if one has a form of strabismus. First, the patient's history will be taken in order to assess their general health, and an eye exam is given to look for any abnormalities.
Then refraction, alignment, and focusing tests will be done to see how the eyes respond. Visual acuity tests will be administered to see how close to normal 20/20 vision the patient has. Eye drops may be used during the tests to temporarily keep the eyes from changing focus.
Treatment Options
Glasses or contacts are given to those with accommodative esotropia to correct the farsightedness.
Prism lenses can be given to alter the amount of light that enters the eye and assist in reducing the amount of turning an eye has to do to see objects clearly.
Vision therapies are visual activities that may be suggested to improve eye coordination and focusing abilities.
Eye patches or atropine drops may be used to block the straighter eye and make the weaker one work better.
Eye-muscle surgery may be necessary to change the length or position of eye muscles.
The earlier strabismus is diagnosed and treated, the more likely it is to be corrected; however, some teenagers and adults have had luck alleviating the condition later in life as well.
Thank you so much for writing this article. My daughter had a vision screening earlier this year and was referred to a specialist because she has a hard time focusing when reading the vision chart. I was not givin a complete explannation on what could be happening and why and I think that the information provided in this article has helped me understand. I have a lazy eye and her father has a wondering eye and maybe she inherited one of our if not both of our eye problems.I wear glasses and I now think there’s a strong possibility that she will too.
Thank you so much for writing this article. My daughter had a vision screening earlier this year and was referred to a specialist because she has a hard time focusing when reading the vision chart. I was not givin a complete explannation on what could be happening and why and I think that the information provided in this article has helped me understand. I have a lazy eye and her father has a wondering eye and maybe she inherited one of our if not both of our eye problems.I wear glasses and I now think there’s a strong possibility that she will too.
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