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Strabismus In Children


  • Strabismus (strah-BIZ-mus) is a childhood condition where one eye is weaker than the other eye. It appears as if each eye is looking in a different direction. It is also called squint, walleye, or crossed-eyes. Your child may be born with the condition or have it as he is growing up. It appears early in childhood and can last until adulthood if not treated as soon as possible. You may notice your child looking at you with one eye closed or his head turned to the side. He may have frequent headaches, eyestrains, or eye discomfort.
    Picture of a normal eye
  • Your caregiver may notice the condition as he looks at your child. Tests to know how well your child's eyes are working may be done. This includes tests to check on the muscles, nerves, and blood vessels of the eyes. Treatment includes the use of corrective glasses or contact lenses, or an eye patch on the stronger eye. Medicines to correct eye problems and treat eye muscles may be given. Surgery to correct problems with the eye muscles may be done if the condition is severe (bad). Having strabismus diagnosed and treated as soon as possible may improve your child's vision and quality of life.


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.


  • Surgical treatment of strabismus carries certain risks. Your child may bleed more than expected or get an infection. The surgery may not be successful for the first time and may need to be done again. Your child may have scars on his eyes after the surgery. Your child may get an allergy to the eye medicine. Injection of the medicine to treat problems in the eye muscles may cause ptosis (dropping of the eyelid). The use of an eye patch may embarrass your child. Using contact lenses may bring eye discomfort.
  • If left untreated, your child may lose the vision (eyesight) on his weaker eye. He may carry the burden of having crossed eyes as he grows up. Call your child's caregiver if you have more questions or concerns regarding your child's condition, treatment, or care.


Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.


Your child may be given:

  • Miotic agents: These medicines are given to make the pupil (black circle in the middle of the eye) constrict (get small). This may help your child focus on an image better.


Your child may need any of the following eye tests:

  • Cover uncover test: For these tests, your child stares at an object near and far. One eye is covered with a special material. Your child's caregiver will watch for the response of each of your child's eyes when the other is covered then uncovered.
  • Fundoscopic test: This test uses a special device with light that is directed to see the blood vessels inside the eyes. Your child is brought into a dark area of a room. While seated, your child may be asked to look at an object. The device is brought slowly closer to your child's eyes. Your child's caregiver controls the light that enters through the eyes to look for problem areas inside.
  • Light reflex test: Your child's caregiver examines your child's eyes by 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 the light reflecting off on each eye.
  • Neurologic signs: These are also called neuro signs, neuro checks, or neuro status. During a neuro check, caregivers see how your child's pupils react to light. They may check his memory and how easily he wakes up. His hand grasp and balance may also be tested. How your child responds to the neuro checks can tell caregivers if his illness or injury has affected his brain.
  • Refraction test: This test checks the lens of your child's eyes. Your child may be asked to try to wear glasses with lenses of different thickness. Your child will be asked to read or tell his caregiver which lens makes the words or pictures the most clear.
  • Visual acuity test: This test uses charts with letters, pictures, and shapes to check how well your child sees. Your child is seated, and he is asked what he sees on the chart placed farther down the room. There are special charts that can be used for children who cannot read or speak yet. Your child's caregiver tests visual acuity by looking at your child's reactions when he holds up objects or charts.

Treatment options:

  • Botulinum toxin (Botox): This is medicine injected into the muscle of the eyes. The medicine may cause temporary (short period) loss of function to the stronger muscles. It helps the muscles of the weaker eye improve the ability to focus.
  • Correction of refraction: This includes the use of glasses, bifocal lenses, or prisms (see-through glass that reflects light) that may help improve your child's vision.
  • Occlusion therapy: This includes the use of an eye patch. The patch is worn on the stronger eye making the weaker eye work more to improve its function.
  • Optometric vision therapy or orthoptics: This includes active exercise techniques for the eye muscles. It is done to improve sensory and motor function of the eyes. It may be used alone or in combination with refractive correction.
  • Surgery: This is done to correct the muscles surrounding the eyes. Caregivers may adjust the length or position of the muscles to align the eyes.

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Strabismus In Children (Inpatient Care)

Micromedex® Care Notes