Q. Strabismus or Squint

A. Strabismus is a condition in which the eyeballs are not aligned and point towards different directions. One eye may look straight while the other eye deviates inward, outward, upward or downward. The straight eye may also turn in while the deviated eye can look straight. It may be constant or it may come and go.

Exotropia. Eye deviates outward.

Esotropia. Eye deviates inward.

Q. What causes Strabismus?

A. The exact cause of strabismus is not fully understood.

Six eye muscles attached to the outside of each eye control eye movement. To line up and focus both eyes on a single target, all of the muscles in each eye must be balanced and working together. For the eyes to move together, the muscles in both eyes must be coordinated.  The brain controls these eye muscles.

Q. What is Pseudostrabismus?

A. The main sign of strabismus is an eye that is not straight.  However, the eyes of some infants may sometimes appear crossed but they are actually not.  This condition is called pseudostrabismus.  Young children often have a wide, flat nose and a fold of skin at the inner eyelids can make the eyes appear crossed.

Q. What are the symptoms of Strabismus?

A. Patients with strabismus may experience double vision (diplopia), loss of depth perception, or a “pulling sensation” around the eyes. To correct their inability to focus properly, the patients may have to tilt or turn their heads.

Q. How is Strabismus treated?

A. In some cases, eyeglasses can be prescribed to straighten eyes. Other treatments may involve eye muscle surgery, prism glasses and Botox injections.

Strabismus surgery or Eye muscle surgery is the most common treatment for strabismus. Typically, strabismus occurs when the muscles surrounding the eyes are either too strong/stiff or too weak.  An ophthalmologist can surgically loosen the strong /stiff muscle or tighten the weak muscle so that the eyes can be rebalanced to work together.

Prism eyeglasses can correct mild double vision associated with adult strabismus. A prism is a clear wedge-shaped lens that displaces the image on the deviated eye to realign with the straight eye.  The prisms can be worn on the outside of the eyeglass frame like a sticker or it can be manufactured directly into the lens itself.

Botox injections. If an “over-reactive” eye muscle is the cause of strabismus, Botox injection can stabilize the muscle and relieve the symptoms of strabismus.  Botox is a drug that when injected in small amounts temporarily paralyzes or weaken muscles.  When injected into the eye muscle, the effects can last several months and may even result in a permanent change in eye alignment.