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Strabismus

Strabismus is misalignment of the eyes (sometimes called "crossed eye"), which makes it impossible for the brain to use the information from the two eyes together normally. Its forms include: esotropia, when one eye turns inward relative to the other; exotropia, when the eyes turn outward; hypertropia, upward; and hypotropia; downward. Often, patients have a combination of more than one form. Children with strabismus from an early age do not see double, because their brains suppress the visual information from one eye. In more than half of cases in children, the problem is present at or shortly after birth (congenital strabismus). Strabismus can occur from paralysis of one of the nerves innervating the eye muscle(s). Some children with strabismus develop amblyopia.

  •  Esotropia, when one eye turns inward relative to the other.
  •  Exotropia, when the eyes turn outward.
  •  Hypertropia, when the drifting eye is higher than the other eye.
  •  Hypotropia, when the drifting eye is lower than the other eye.

Diagnosis
Strabismus is sometimes noticed by parents and sometimes diagnosed by pediatricians. With early diagnosis, the defect can usually be corrected.The best way to diagnose strabismus, determine the cause and the best treatment is through a detailed evaluation by a pediatric ophthalmologist, which often include dilating eye drops for measurement of refractive error.

Treatment
Treatment is a function of many factors: the type of strabismus, the child's age, vision, whether or not the strabismus is constant, and the child's refractive error. Treatment can include observation, eye glasses that control eye alignment or surgery that shifts eye alignment. The best treatment for one type of strabismus may be completely inappropriate for a different type of strabismus.