Strabismus

Somewhere early in a child’s development, the brain fails to develop binocularity—the ability to use both eyes at the same time.

Strabismus, commonly known as eye turn or crossed eyes, is a vision condition in which a person cannot align both eyes simultaneously under normal conditions.

Strabismus may originate in the muscles themselves or in the nerves / vision centres in the brain that control binocular vision.

Kids with strabismus may have one or both eyes turning inwards, outwards, upwards or downwards. The eye turn may be constant or parents may only notice it occasionally (e.g., when their child is tired or looking at something very close up).

When the eyes point in two different directions, they see two different things. To prevent double vision, the brain ignores the image sent by the misaligned eye (suppression).

The more the brain ignores the misaligned eye, the more the vision in that eye deteriorates (a condition known as amblyopia or “lazy eye”), while the straight or straighter eye becomes dominant. If no treatment is given, this may cause permanent vision loss in the amblyopic eye.

In many cases, strabismus is not just an eye muscle issue but how the eye is “wired” to the brain. This explains why an eye turn doesn’t completely go away in some patients even after eye muscle surgery.

Signs and Symptoms Your Child May Have Strabismus Include...

Crossed eyes or eyes that appear to move independently of each other
Child complains of double vision
Eyestrain and headaches

Inability to read comfortably, fatigue when reading
Frequent rubbing of eyes

Why Should Parents Be Concerned?

The most common effect of strabismus on kids may be a feeling self-consciousness of how they look. However, the negative impact strabismus has on children goes beyond the aesthetic or what they feel when other people notice their eyes. Untreated strabismus may lead to permanent vision loss.

Children often adapt by suppressing (turning off) the image from the turned eye, which may lead to amblyopia, impaired depth perception (stereopsis) or the ability to see in 3D. Failure to detect or waiting too long to start treatment may lead to permanent vision loss of the affected eye.

Surgery may fix the structural aspect of an eye turn by straightening the eye, but may fail to fix the functional aspect (how the brain processes what the eye sees). We had tested patients whose eye turn returned post-surgery, with their parents unaware that something was wrong because their child’s eyes looked aligned!

An eye turn that is left alone may negatively affect the child’s quality of life even as they become adults. This may cause emotional issues (e.g., difficulty forming meaningful relationships because of lowered self-esteem) as well as practical (e.g., limited career choices, difficulty driving, etc.)

How Can We Help?

Comprehensive Eye Test

Strabismus doesn’t go away on its own, but when recognised and treated effectively, strabismus can be cured. Our first step is to detect if there is indeed strabismus in your child during our comprehensive eye test so that we can begin immediate treatment plan.

Parent and Child Education

We’ll help you understand your child’s eye turn, answer your questions and find the appropriate treatment for your child which may include spectacles, patching, atropine, vision therapy or a referral for surgery.

Help Make the Eyes Work Together

Our vision therapist may demonstrate some visual activities and exercises designed to help your child’s two eyes work together as a team and help them learn how to maximise their visual potential and make them see better!

Improved Visual Skills that Last

We aim that after treatment, your child will have improved ability to control an eye turn, improved distance judgment and 3D vision (depth perception), improved symptoms of headaches, sore eyes and double vision, and improved learning ability, reading level and speed.