Strabismus is a problem caused by one or more improperly functioning eye muscles, resulting in a misalignment of the eyes. One eye, or sometimes both, may turn in (esotropia), turn out (exotropia), turn up or turn down (hypertropia or hypotropia, respectively). Sometimes more than one of the turns is present.
Strabismus must be detected early in children because they are so adaptable. If a child sees double, his or her brain quickly learns to suppress or block out one of the images to maintain single vision. In a very short time, the brain permanently suppresses vision from the turned eye, causing amblyopia.
Children may also develop a head tilt or turn to compensate for the problem and eliminate the double image. Unlike children, adults with a newly acquired strabismus problem typically see double.
There are many causes of strabismus. It can be inherited, or it may be caused by trauma, certain diseases, and sometimes eye surgery. Strabismus cannot be outgrown, nor will it improve by itself. Treatment to straighten the eyes is required. The types of treatments may be used alone or in combination, depending on the type of strabismus and its cause.
Glasses are commonly prescribed to improve focusing and redirect the line of sight, enabling the eyes to straighten. Medication in the form of eye drops or ointment may be used, with or without glasses. Injected medication may be used to selectively weaken an overactive eye muscle.
Surgery may be performed on eye muscles to straighten the eyes if non-surgical means are unsuccessful. Eye exercise, a limited form of treatment, may be recommended either before or after surgery to teach proper eye coordination.