Strabismus In Children

What is strabismus?

Strabismus is a condition where your child's eyes point in different directions. It is also called squint, crossed eye, or walleye. Your child's eyes do not focus on a single point. His eye muscles do not work properly to control his eye movement.

Lateral cut-away of the Right Eye

What causes strabismus?

  • Weak or paralyzed eye muscles

  • Brain injury that damages eye function

  • Tumors that press on the muscles or nerves around the eyes

  • Damage to or inflammation of the retina in premature babies

What are the signs and symptoms of strabismus?

  • Your child's eyes wander or cross.

  • Your child says his eyes hurt or are tired after reading or focusing on an object.

  • Your child looks at you with one eye closed or his head turned to the side.

  • Your child has headaches.

  • Your child has blurred vision, double vision, or increased sensitivity to bright lights.

How is strabismus diagnosed?

Your child's caregiver will ask about your child's symptoms and examine his eyes. Your child may need any of the following tests:

  • Visual acuity test: This test uses charts with letters, pictures, and shapes to check how well your child sees.

  • Cover test: Your child looks at an object with one eye covered. Then your child looks at the object with the other eye covered. The caregiver will watch your child's eyes to see how they respond.

  • Light reflex test: Your child's caregiver examines your child's eyes using a penlight. The light is flashed in front of his eyes and moved slowly from side to side. Your child's caregiver will compare how each eye reacts to the light.

  • Fundoscopic test: This test uses an instrument with a bright light to check for damage to the blood vessels inside the eyes. The lights are dimmed and your child is asked to look at an object. The device is slowly moved closer to your child's eyes.

  • Refraction test: This test checks the lens of your child's eyes. Your child may be asked to wear glasses with different lenses. He will be asked to read or tell his caregiver which lens makes the words or pictures the most clear.

How is strabismus treated?

  • Eye patch: The patch is worn on the stronger eye to help the weaker eye work more and get stronger.
    Eye Patch


  • Eye exercises: Encourage your child to read books or draw and color pictures. This will help exercise his eye muscles and improve his vision. Ask about the best eye exercises for your child.

  • Corrective eyewear: Glasses or contact lenses may decrease your child's need to squint to focus on an object. This helps straighten your child's eyes.

  • Surgery: Caregivers change the length or position of the muscles to straighten the eyes.

What are the risks of strabismus?

  • Contact lenses may cause discomfort. Your child may bleed more than expected or get an infection after surgery. He may need more than one surgery. He may have scars on his eye muscles after surgery.

  • Without treatment, your child may develop a lazy eye. He may have double vision or lack of depth perception. He may lose his vision in the weaker eye. His eyes may point in different directions permanently.

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • Your child has a fever.

  • Your child has blurred or double vision.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your child loses vision in his eye.

  • Your child has a severe headache, dizziness, or vomiting.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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