There are many different types of strabismus, described by the direction of the misalignment. It is sometimes called wandering or wall eye when the eye turns outward, or crossed eye when the eye turns inward, or deviating eye, where one eye is looking at the target and the other eye may be horizontally, vertically and rotationally misaligned. Sometimes it is a combination of misalignments.Often, it is constant, which means the same eye is always deviating. Occasionally, it is intermittent and noticeable only at times. It can also alternate, sometimes the right eye is the culprit, sometimes the left.
Strabismus is more common in people with a family history of the condition, and children who were born prematurely. Most of the time, it is the result of an abnormality of the neuromuscular (including brain) control of eye movement. Uncorrected far-sightedness and focusing problems are other possible causes of strabismus in children. Some children are born with a defective visual processing centre in the brain.
An adult may have strabismus that persisted from the time he or she was a child, and it was either unsuccessfully treated in childhood or has recurred after a period of time. Adults can also face it as a result of other conditions, including loss of vision in one eye as a result of diseases in the eyes such as glaucoma, or retina abnormalities; trauma to the eye or eye socket, causing damage to the eye muscles or the nerves that send messages to move the eye muscles; neurologic disorders, such as strokes and head trauma that affect the signals from the brain to the eye muscles; or other medical conditions such as diabetes or thyroid disease, in which the muscles or nerves that move the eyes do not function properly.
SIGNS AND SYMPTOMS
Family members are usually the first to notice that a child’s eyes are misaligned. Some signs of strabismus are unusual head tilting or face turning, squinting, closing one eye when gazing carefully at something or going into the sun, clumsiness, or the appearance of not looking directly at the object of regard. Older children and adults will frequently complain about double vision and loss of depth perception.
Strabismus cannot be outgrown, and treatment to straighten the eyes is required. It is never too late to restore normal alignment to the eyes, and treatment will depend on the type of strabismus and its cause. Some cases respond very well to glasses.
There are many positive and life-changing reasons to treat this condition. Straightening crossed eyes improves vision, aligns the eyes and head, enlarges the visual field and restores depth perception. This means that double vision is eliminated and a sense of well-being restored. Since eye contact is so essential in human interaction, having straight eyes is important psychologically and socially as well. Treatment improves self-image, ability and confidence to interact, and enhances employment opportunities.
Surgery for strabismus is typically an outpatient procedure and involves loosening or tightening the muscles that move the eye from side to side. This will change the pull of the eye, and correct the condition.