Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 1998;58(3):703-704

See related article on pediatric vision screening.

What is strabismus and how do I know if my baby has it?

The problem of crossed or wandering eyes is called strabismus (say: stra-biz-muss). It's normal for newborn babies to have eyes that cross or wander sometimes, especially when they're tired. However, if you see your child's eyes cross or see one eye wander to the side after three months of age, even if it happens only once in a while, tell your doctor. Also, if your child often looks at you with one eye closed, or with his or her head turned to one side, tell your doctor.

Why is strabismus a problem?

Normal vision needs both eyes to look in the same direction at the same time. When a child has a crossed or wandering eye, he or she gets a different picture from each eye. The child's brain blocks out the picture from the weaker eye. If this eye isn't fixed when a child is young, the child's brain will always ignore the pictures from the weak eye. This kind of vision loss is called amblyopia (say: am-blee-o-pee-ah). This is the most serious problem caused by crossed or wandering eyes.

What can be done to fix this problem?

Treatments can help your child to have normal vision. The earlier the treatment is started, the better. The goal of treatment is to make the weak or wandering eye do more work. Sometimes this means the child has to wear glasses. Or the child might wear a patch on the “good” eye or have drops put in it. Your child may not like to have these treatments, because the weak eye doesn't see as well as the other eye. Even if your child doesn't want to wear glasses or an eye patch, this treatment is very important. It can help your child see better as a child and as a grown-up.

Some children need an operation to straighten their eyes. The operation is usually not done until the weak eye has gotten stronger by being used more. The surgery is fairly simple, but it doesn't always make the eyes exactly straight. Sometimes it has to be done again later on.

How long does the treatment last?

Since the most important part of treating strabismus is to force the weak eye to work harder, it's very important that you follow the directions for eye patching or eye drops that the doctor gives you. Usually the treatment will go on for many months, or even a few years. Sometimes less patching (or fewer eye drops) will be needed as time goes by. This treatment usually helps make the weak eye as strong as the good eye.

When your child is about seven or eight years old, the vision in the weak eye will be as good as it can get with treatment. The earlier treatment starts, the easier it is to fix the problem. So watch for signs that your child doesn't see well, or for eyes that cross or wander apart. If you have any questions, always ask your family doctor.

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