Strabismus
Introduction to Strabismus
Strabismus, also known as crossed eyes, is a condition in which the eyes
don't look towards an object together. One of the eyes may look in or out, or
turn up or down. The eye turning can occur all of the time or only sometimes,
such as during stressful situations or illness.
What Causes Strabismus?
Some people are born with eyes that do not align in the usual way. This is
called congenital strabismus. In many children, there is no clear cause of
strabismus. In some cases, it is a result of a problem with the nervous system,
especially the part that controls the muscles of the eyes. If it is not
corrected, strabismus can continue into the adult years. Most adults who have
strabismus were born with it.
If strabismus does not appear until later in life, it will cause double
vision. If the eyes become misaligned in an adult who did not have strabismus as
a child, it could be a sign of a serious condition such as a stroke. A sudden,
misalignment of the eyes or double vision are important reasons to see a doctor
immediately.
Someone who is born with strabismus will see without having double vision.
There might be other effects on vision, however. Because the two eyes are not
working well together, depth perception and peripheral vision (vision off to the
side) will not be very good. Eyestrain and headaches can occur frequently. It
might also be necessary to turn the head in unusual ways in order to see in
certain directions.
How Is Strabismus Treated?
A doctor may recommend that patients go through physical therapy to help
strengthen their eye muscles. Vision therapy is also used to help a person
correct their vision when suffering with strabismus. This therapy helps train a
patient's brain to be able to align their eyes and focus and visually process
images. Vision therapy uses computerized optical devises, including lenses and
filters, to develop the eye muscles.
Is Surgery an Option to Treat Strabismus?
Yes. Surgery to correct strabismus is performed to strengthen or weaken the
effect of one or more of the muscles that move the eye. When this procedure is
performed on adults, it is usually done under local anesthesia. (The eye is
numb, but the patient is awake.)
The surgeon will first make an opening into the outer layer of the eyeball.
This allows the surgeon to reach the muscle that will be strengthened or
weakened.
Strengthening the muscle means removing a small section from one end and then
stitching it back together. This makes the muscle shorter, which tends to turn
the eye toward the side of that muscle.
"Weakening" the muscle means making a cut across one end, but not removing
any of the muscle to shorten it. Instead, a gap is left where the muscle was
cut, and the ends of the muscle are tied back together with a suture (thread).
This has the effect of making the muscle longer, which lets the eye turn further
away from the side of that muscle.
At the end of the procedure, the surgeon will close the opening in the eye
with stitches. The patient will often have double vision for a few weeks after
surgery. This goes away as the brain adjusts to the new way of seeing.
Reviewed by the doctors at The Cleveland Clinic Cole Eye Institute.
Edited by
Charlotte E. Grayson, MD,
WebMD, October 2004.
Portions of this page ©
The Cleveland Clinic 2000-2004
Last Editorial Review: 6/20/2005
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