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Glossary of Conditions

Accommodative esotropia
Accommodative esotropia is when the eyes cross due to the automatic focusing mechanism of the eyes (accommodation) when the eyes try to see clearly. Patients with accommodative esotropia are hyperopic (farsighted), so the crystalline lens inside the eye must work harder to focus images for the eye to see clearly, especially when an object is up close. This effort of the crystalline lens is called accommodation. In patients who have accommodative esotropia, the increased effort for accommodation causes excess convergence or crossing of the eyes, especially up close. It is important to note that most children are slightly farsighted and do not have any esotropia. The more farsighted a child is, the more likely they are to have accommodative esotropia due to the increased accommodative effort. Crossing of the eyes is not normal, and any child with crossing eyes should be examined by a pediatric ophthalmologist.

What is the treatment for accommodative esotropia? The first treatment is glasses to correct the hyperopia (farsightedness). This allows the eyes to relax the accommodative effort, because the glasses are doing the work to focus images clearly on the retina. Subsequently, this reduces the eye crossing and the eyes will straighten. It is important to note that glasses to treat this condition must be worn full time, and that the eyes will continue to cross inward toward the nose when the glasses are not worn. This is normal, because what the glasses do is relax the accommodative effort necessary for the eyes to see clearly and therefore straighten out the eyes. Therefore, when the glasses are off, the eyes must work extra hard to accommodate to see clearly, which drives the eyes to cross inward.

Even after a child has been wearing glasses to treat this condition, the eyes will sometimes continue to cross inward. If the eyes are not straight with the glasses on, then the visual system will not be able to develop properly and additional treatments may be necessary. Your pediatric ophthalmologist will assess your child’s progress at regular check-up visits. The ophthalmologist will be able to check for associated problems like amblyopia (vision loss affecting one or both eyes) or the need for surgery in addition to glasses in order to treat the eyes crossing. Surgery is indicated when the eyeglasses alone are not enough to adequately straighten the eyes. Eye muscle surgery may be recommended in this case in order to align the eyes for a better prognosis for your child to use the eyes together. Usually this surgery does not eliminate the need for glasses. What it does is fix the amount of crossing that is “left over” which the glasses prescription does not correct fully. When the glasses are off, the eyes will continue to cross. Surgery does not replace the need for glasses.

In some cases, children have an excessive amount of eye crossing at near. These children need even more correction for accommodation than regular glasses can provide. These patients sometimes require extra glasses power to straighten the eyes for objects viewed at near, which is provided through bifocal lenses.  


Amblyopia
Amblyopia, or “lazy eye,” is a problem where one eye is unable to see as well as the other, or when both eyes have decreased vision. It is the most common cause of vision loss in children. Amblyopia occurs when one or both eyes send a blurry image to the brain, and the brain then learns to only see blurry from that eye and may shut off input from that eye (suppress) as a result. Amblyopia can be caused by strabismus (eye misalignment), by an uncorrected refractive error (need for glasses) in one or both eyes, by a difference in refractive error between the two eyes, or by something like a cataract, cloudy cornea, droopy eyelid, or some other factor preventing visual stimuli from reaching the retina. The end result of amblyopia is reduced vision in the affected eye(s). If amblyopia is not treated at an early age, it can cause permanent loss of vision.
What causes amblyopia? Amblyopia can happen for a variety of different reasons.

Strabismic amblyopia develops when the eyes are misaligned. When one eye turns up, down, in, or out, the brain may “shut off” the eye that is not straight, which results in decreased vision in that eye. Visual deprivation amblyopia can happen when cataracts, droopy eyelids, or other similar conditions deprive the young eye(s) of visual stimulation. The affected eye(s) experience decreased vision.

Refractive and anisometropic amblyopia occur when there is a large amount of uncorrected refractive error (need for glasses) in one or both eyes. Usually the brain will “shut off” vision from the eye that has the most farsightedness and/or most astigmatism. Parents are often unaware that there is a problem in children with these types of amblyopia, because the eyes look normal and because the “good” eye has normal vision, so the amblyopia may go undetected unless the child has a vision test. This kind of amblyopia can be helped with treatment if detected early.

How is amblyopia treated? Early treatment for amblyopia is always best. One of the most important amblyopia treatments is the proper prescription for glasses or contact lenses when the child needs it, and consistent use of the glasses or contact lenses. Children with refractive errors that need correction can wear glasses or contact lenses when they are very young if necessary. Amblyopia can also be treated with helping to remove barriers to visual deprivation, for example, surgical cataract removal by an ophthalmologist. Another form of amblyopia treatment is patching therapy.

By using an eye patch over the dominant eye, the child is forced to use and thereby develop vision in the non-dominant eye. Patching should only be done under the supervision of an ophthalmologist and/or orthoptist. Children who undergo patching therapy will have regular check-ups to evaluate how the patch is affecting the child’s vision. It can be very difficult to do, but patching usually is very effective with good cooperation. There are different kinds of patches. The classic patch style is an adhesive patch (like a bandage) which is applied directly to the skin around the dominant eye. They are available in different sizes. Another patch style is a cloth patch to fit over a child’s glasses and block the vision.

In some cases, your doctor may recommend using eyedrops to dilate the pupil and thereby blur the vision in one eye to achieve a similar effect as a patch. Blurring the vision in the stronger eye using the eye drops will penalize the strong eye and force the child to use the weaker eye. This treatment is usually reserved for mild cases of amblyopia or when a child is unable to wear the patch as recommended. Your pediatric ophthalmologist and orthoptist will help you to decide which treatment regimen suits your child and family best. The amount of time that a child wears the patch can vary greatly based on the type and severity of amblyopia, the child’s history, the compliance with treatment, and the way the child responds to the patching therapy. Your pediatric ophthalmologist will direct you as to how long to keep the patch on during the day.

The goal of amblyopia treatment is the best possible vision in each eye. Amblyopia therapy can help to attain visual improvement up until the age of about 14. Responses to amblyopia therapy vary from person to person, and the earlier it is treated, the better the prognosis for visual potential.

Astigmatism
Astigmatism occurs when the front part of the eye, called the cornea, is curved more in one direction than another. The cornea is shaped more like a football than a basketball. This causes light rays entering the eye to come into focus at multiple points in front of and/or behind the retina rather than at one central point on the retina. Astigmatism causes blurry vision both up close and in the distance. Astigmatism commonly occurs with myopia and hyperopia, and may occur on its own. Glasses, or less commonly contact lenses, are a treatment prescribed for significant astigmatism.

Brown Syndrome
Brown Syndrome, or superior oblique tendon sheath syndrome, is a mechanical problem in which the superior oblique eye muscle is unable to move freely as it should. As a result, it is difficult to look up and in with the affected eye. Brown Syndrome may be present from birth or begin later in life.

The eyes usually look normal except when the person looks off to the side. When looking up and toward the affected side, one eye appears higher than the other. The lower eye is the one affected by Brown Syndrome and is unable to elevate while looking in the side gaze direction of the nose. What happens is that the superior oblique muscle tendon is tight and causes a tethering effect, which makes the eyeball unable to move up toward the nose. In some situations the eye turns outward (exotropia) when looking up. Sometimes the eye may move downward as it is turned in. Some patients with Brown Syndrome may turn or tilt the head in order to get the eyes to work together. Sometimes the affected eye can get “stuck” after looking up or down for an extended period of time. The patient may hear a clicking sound when the eye becomes unstuck.

What causes Brown Syndrome?
The exact cause of congenital Brown Syndrome is unknown. There is an abnormality with the superior oblique muscle tendon, the cartilaginous structure that the tendon passes through (called the trochlea), or both structures. These abnormalities causing Brown Syndrome are variable. They may include a thicker than normal tendon, scarring of the tendon, a shortened or abnormally tight sheath around the tendon, or an abnormally reduced elasticity of the muscle and tendon.

Brown syndrome may also be acquired :
-after surgery on the eyelids, sinuses, retina, or teeth;
-after trauma, if the eye socket is hit in the upper corner near the nose; or
-together with inflammatory diseases like sinusitis, systemic lupus, juvenile idiopathic arthritis and adult rheumatoid arthritis.

Is Brown syndrome hereditary?
Hereditary cases of Brown syndrome are rare. Most cases are sporadic with no family history of Brown syndrome.

How is Brown syndrome treated?
Treatment for Brown syndrome is quite variable and may include:
-observation
-systemic or locally injected corticosteroids (for inflammatory causes)
-NSAIDs (for inflammatory causes)
-surgical treatment for select cases

Chalazion
What is a chalazion? A chalazion is a bump on the eyelid. There are tiny glands lining the edges of the eyelids that produce oils to help in the normal lubrication system of the eye. When one of the glands becomes blocked, a chalazion occurs. Oils build up inside the eyelid and form a bump. Certain skin types may be more to developing a chalazion than others.
What are the treatment options for chalazion? Most chalazia resolve on their own over a period of days to months. Applying warm compresses over the affected area can help a blocked gland to drain better. Sometimes eye drops, ointments, or an injection into the bump may be indicated. Persistent chalazion may require surgical drainage by your pediatric ophthalmologist.

Cataract
What is a cataract? A cataract is a cloudiness or opacity of the crystalline lens inside the eye, which is normally clear. Cataracts can range from being large and vision-threatening to small and not vision-threatening. About every 3 in 10,000 children have a cataract. In a normal eye, light enters the eye and travels through the crystalline lens inside the eye to come to a focus on the retina (in the back of the eye) where the retina then transmits signals to the brain for clear vision. A cataract is a clouding of the lens, which causes the image to be blurred or blocked from reaching the retina. This may affect a child’s visual development and result in amblyopia. There are many different types of cataracts:
-A lamellar cataract is cloudiness between the nuclear and cortical layers of the lens.
-A nuclear cataract is cloudiness of the center part of the lens.
-A posterior subcapsular cataract is a thin layer of cloudiness that affects the back surface of the lens cortex, just inside the capsule.
-An anterior polar cataract is a small, usually central opacity of the front part of the lens capsule. Anterior polar cataracts generally do not grow during childhood and are typically not visually significant. They are often managed non-surgically.
-A posterior polar cataract is a central opacity at the back of the lens.
-Persistent fetal vasculature is often associated with a cataract. During normal development of the eye, there is a blood vessel that extends from the optic nerve in the back of the eye to the developing lens to provide the growing lens with nutrients. This blood vessel normally disappears during development. If it fails to regress, however, it can result in a cataract on the back of the lens. These cataracts are often more challenging to treat and have a worse prognosis because they are associated with other ocular abnormalities.

-Traumatic cataract results from either a blunt or penetrating force that causes damage to the lens inside the eye. The cataract can form shortly after the trauma, or months to years after the injury.
How is a cataract treated? Cataracts in babies and children need to be evaluated right away, as shortly after birth as possible. Some cataracts need to be removed if they are interfering with visual development. These cataracts should be surgically removed by your pediatric ophthalmologist as soon as is safely possible, especially if the child was born with the cataract. Other cataracts are small and/or off center in the lens. These cataracts do not need to be removed if vision is developing normally. Glasses and/or patching therapy may be helpful for visual development and in some cases surgery can be delayed or avoided completely. Cataract surgery is, in general, very safe. However, every surgical procedure has risks. The risks of pediatric cataract surgery include the possibility for infection, retinal detachment, glaucoma, displacement of the intraocular lens, development of cloudiness in the lens capsule (“secondary cataract”) and development of cloudiness in the vitreous inside the eye.

Conjunctivitis
What is conjunctivitis? Conjunctivitis, or “pink eye,” is a condition where the eyes may burn, itch, or feel irritated. The eyes look pink or red and may have discharge or crusting of the eyelashes. It is caused by a variety of different allergies, bacteria, or viruses and it is highly contagious when caused by bacteria or viruses. It is important to see a pediatric ophthalmologist when the eye looks pink, because there are other possible causes for this in addition to conjunctivitis.
How is conjunctivitis treated? After your pediatric ophthalmologist evaluates the conjunctivitis, it may be treated with antibiotic eye drops or ointment. Conjunctivitis due to allergies can be treated with allergy eye drop.

Duane Syndrome
Duane syndrome, or Duane retraction syndrome, is a problem with miswiring of certain eye muscles, which is present from birth. Current research suggests that this miswiring probably occurs around the 6th week of pregnancy. It is due to tiny segments in the brain stem that control eye muscles developing in an atypical fashion. People who have Duane syndrome have a hard time rotating the eye outward toward the ear (abduction) or inward toward the nose (adduction). In Duane syndrome, the sixth cranial nerve which controls the muscle that pulls the eye out towards the ear (called the lateral rectus muscle) does not develop properly for unknown reasons. The nerve that sends directions to the muscle does not function properly. A part of the third cranial nerve also is affected, and the innervation to the third cranial nerve is also irregular. The third cranial nerve controls the muscle that allows the eye to move inward toward the nose (called the medial rectus muscle).

There are three different types of Duane syndrome.
TYPE 1: The affected eye is unable to move out toward the ear (abduct). The eye may be esotropic, or turned in toward the nose. This is the most common type of Duane syndrome. Patients will often turn their head toward the affected side.
TYPE 2: The affected eye is unable to move in toward the nose (adduct). The eye may be exotropic, or turned out toward the ear.
TYPE 3: The affected eye is unable to move in toward the nose (adduct) or move out toward the ear (abduct).

What is the treatment for Duane syndrome?
Most patients who have Duane syndrome do not require surgical treatment. With careful follow-up, patients usually have an excellent outcome in terms of prognosis for good vision. In some cases, eye muscle surgery may be indicated in order to help the patient use both eyes together, to reduce the amount of eye misalignment (strabismus), or to correct  an unacceptable head position. In some cases, Duane syndrome may be associated with other problems, including nystagmus or involuntary eye shaking, cataracts, optic nerve problems, microphthalmos (abnormally small eye), crocodile tears, Goldenhar syndrome, or spinal anomalies.

Esotropia
Esotropia is an intermittent or constant turning in of one or both eyes toward the nose. It may happen at any age and may happen when a patient is looking at things up close, in the distance, or both. Esotropia at any age beyond 4 months should be evaluated by a pediatric ophthalmologist.
There are many different types of esotropia. It can be classified according to age of onset (infantile esotropia or acquired esotropia). It can also be classified by frequency (intermittent or constant esotropia) or by whether it improves with glasses treatment (accommodative esotropia). Esotropia can also occur secondary to other conditions, such as amblyopia (poor vision in one eye) or neurological conditions such as hydrocephalus, stroke, or cranial nerve problems. Prematurity, a family history of eye misalignment, and various neurological and genetic disorders increase the risk for eye misalignment. Esotropia can also occur secondary to medical conditions such as Grave’s disease, diabetes, and many others. Your pediatric ophthalmologist will inform you of which type of esotropia you or your child has.

Esotropia can cause other problems with the eyes, depending on the patient’s age, the type of esotropia, and the severity of the eyes crossing. Esotropia affects the ability of the eyes to work together. It may result in diplopia (double vision), a decreased area of binocular single vision, a loss of depth perception or 3-D vision, or loss of vision in the crossing eye (amblyopia).

How is esotropia treated? Esotropia can be treated with glasses or contact lenses--sometimes glasses with prisms or bifocals are prescribed. Your pediatric ophthalmologist can treat esotropia with eye muscle (strabismus) surgery. Sometimes more than one surgery may be needed to fully correct the esotropia. Some types of esotropia can be treated with botulinum toxin injections to the eye muscle(s).

Exotropia
Exotropia is a type of strabismus, or eye misalignment, when one eye turns out toward the ear. It may be intermittent or constant, and it may occur in one eye, both eyes, or alternate from one eye to the other. Exotropia may happen on occasion and cause little or no problems. In some people, it may become more frequent as they age or progress to the point of becoming a constant problem. People who have intermittent exotropia may experience the outward drifting of the eyes only occasionally, such as when they are tired or ill. Some children with intermittent exotropia will quint or close one eye in bright sunlight. Some people are aware of their eye turning out and can “feel” it, and others cannot. Some people experience double vision when the eye is misaligned, and others may not.

Sometimes people have an eye with poor vision, or amblyopia, that turns outward. This is called sensory exotropia. In these cases, surgery to realign the eyes is often an option.
How is exotropia treated?

Non-surgical treatment for exotropia may include glasses. Sometimes patching therapy may be used, as well. If the eyes are misaligned grater than 50% of the time, eye muscle surgery (strabismus surgery) may be recommended in order to realign the eyes. In general, surgery is indicated when the exotropia is present more often than not, when it is causing symptoms of eye strain, double vision, or squinting, or when the patient is losing the ability to focus the eyes together. If the exotropis can be successfully controlled with nonsurgical options, surgery may not be recommended.

Is exotropia hereditary? Strabismus does tend to run in some families. Other family members do not necessarily have the same type of strabismus; they may have an eye that turns in (esotropia) turns up (hypertropia) or turns down (hypotropia), or some other form of eye misalignment. A family history of strabismus is a good reason to have your child evaluated by a pediatric ophthalmologist.

Fourth Nerve Palsy (superior oblique palsy)
A fourth nerve palsy is a weakness of the fourth cranial nerve, which innervates the superior oblique muscle in each eye. This causes a misalignment of the eye in the vertical, horizontal, and torsional (rotation) directions. Typically the vertical misalignment is the most noticeable feature of a fourth nerve palsy, because the eye is unable to move down normally and is misaligned so that it is up higher than the other eye. A fourth nerve palsy can involve one eye (unilateral) or both eyes (bilateral). A superior oblique palsy may cause double vision (diplopia) because the misaligned eyes causes the brain to perceive two separate images from two different directions. The double vision may be vertical (one image on top of the other), diagonal (images are both vertically and horizontally offset), or torsional (one image looks rotated or tilted).

It is common for patients with a superior oblique palsy to tilt or turn their head to one side. This abnormal head position allows for better eye alignment and can sometimes help to eliminate double vision.
What causes a fourth nerve palsy? Fourth nerve palsy is most commonly congenital and present from birth. Another common cause of superior oblique palsy is head trauma, including concussions or whiplash from car accidents. Other less common causes can include stroke, tumor, and aneurysm.

How is a fourth nerve palsy treated? Your pediatric ophthalmologist will identify the cause for the fourth nerve palsy and treat the underlying cause first. Once the cause has been treated, the ophthalmologist will typically wait six months to see if the fourth nerve palsy resolves. Sometimes this condition is treated with prisms, patching one eye, or covering one eye. The treatment of choice for most superior oblique palsy is eye muscle surgery. Surgery can help to eliminate double vision, to help correct a head tilt, and to reduce the upward deviation of the eye. Eye muscle surgery can be performed on one or both eyes. The amount of surgery depends on how misaligned the eyes are, the change in the eye misalignment in different directions of gaze, the amount of torsion (eye and image tilting) and the amount of head tilting.

Glasses for Children
Why does a child need glasses? During the first few years of life, a child’s eyes and visual system are rapidly growing and developing. Glasses in children help to ensure normal development of vision. Children can need glasses for many reasons. One reason for glasses wear may be to provide a sharper quality of vision (to correct refractive error such as myopia, hyperopia, or astigmatism) so that a child may see clearly. Glasses can also be prescribed to help straighten the eyes when they are crossed or misaligned due to strabismus. Glasses can also be used to help strengthen the vision in a weak eye (amblyopia) or to help strengthen an amblyopia due to a significant difference in prescription between the two eyes. Sometimes, glasses are prescribed to provide protection for one eye if the other eye has poor vision. An ophthalmologist can detect the need for glasses through a complete eye exam.

How will I get my child to wear glasses? Initially, some children may show a resistance to wearing their glasses. The good news is, it usually gets easier because the child will realize that the glasses help their vision and will keep them on more happily. If a child is totally uncooperative, your pediatric ophthalmologist may prescribe eye drops to help the child’s eyes adjust to the new glasses.

Glaucoma in Children
Glaucoma is a problem when the pressures inside the eye are too high. This causes optic nerve damage and can result in vision loss. The pressure inside the eye can be too high for different reasons, it usually happens because the eye produces fluid that it needs but is unable to drain the fluid out of the eye. Infants and children with glaucoma usually have different signs and must be managed differently than adults with glaucoma. Congenital glaucoma is present at birth. Infantile glaucoma develops between the age of 1-24 months. There is also a type of glaucoma with onset after three years of age, which is called juvenile glaucoma.

Most cases of glaucoma in children and infants are considered primary glaucoma, meaning that they have no specific cause that can be identified. There can also be secondary glaucoma, which is when glaucoma is caused by or associated with a specific disease or condition. Some of the conditions that can be associated with glaucoma include Sturge-Weber syndrome, neurofibromatosis, Axenfeld-Reiger syndrome, aniridia, long-term steroid use, trauma, or previous eye surgery. Incidence of glaucoma in these patients is much higher than for the average person. Some types of pediatric glaucoma are hereditary, there are very specific gene mutations that cause this.

Hyperopia
Hyperopia, also known as farsightedness, is a condition when someone is able to see images more clearly in the distance than up close. This condition occurs because light rays entering the eye through the pupil come to a focus at a point behind the retina, because the eye has insufficient focusing power or is anatomically shorter than usual. Children sometimes use the crystalline lens inside the eye to compensate for this on their own by using a focusing technique, called accommodation. A large amount of farsightedness, or high hyperopia, may require correction with glasses or contact lenses. Some children have an associated condition called accommodative esotropia, when the accommodation focusing technique causes the eyes to cross inward toward the nose – these children can benefit from glasses to correct the refractive error and thereby lessen or diminish the secondary eye crossing problem. In general, hyperopia progresses until early childhood and then regresses toward the preteen years.

Myasthenia Gravis
Myasthenia gravis is an autoimmune disease. It develops when auto-antibodies attack normal muscle tissue inside the body and cause it to become weaker than normal. Nerve endings that provide energy to the muscles usually release a chemical called acetylcholine to induce muscle contraction. In myasthenia gravis, antibodies attach themselves to the acetylcholine on the muscle, so that when the acetylcholine is released and tries to induce muscle contraction, the receptors are unable to attach to the muscle and function properly. This results in muscle weakness and fatigue. It happens in both kids and adults and it can affect different muscle groups inside the body. Myasthenia gravis can affect the muscles around the eye and in the face, which can cause droopy eyelids (ptosis), double vision, muscle fatigue, and trouble with breathing and swallowing. The symptoms usually get worse throughout the day and improve with rest.

How is myasthenia gravis treated? A medication called mestinon, or pyridostigmine, blocks the breakdown of acetylcholine and can help to alleviate symptoms. The ptosis and strabismus related to myasthenia can sometimes be helped with surgery. Surgical intervention is only indicated if the strabismus had been stable for a period of time.

Myopia

Myopia, also commonly called nearsightedness, is a condition when someone is able to see clearly up close and images in the distance are blurred. People with myopia need glasses to see images clearly in the distance. Myopia occurs when light ways come to a focus at a point in front of the retina because the eye either focuses too much, or is too long in shape. Myopia can be associated with prematurity or may run in families and can happen at any age. It usually progresses until a person reaches teenage years or early twenties and then tends to stabilize. The treatment for myopia is glasses or contact lenses, which adjust the light rays entering the eye to focus them clearly on the retina and improve vision in the distance.

Nasolacrimal Duct Obstruction
What is a tear duct obstruction? Tears usually drain from the eye through small openings called puncta in the corners of the eyelids, and enter the nose through a structure called the nasolacrimal duct. When the nasolacrimal duct is obstructed, this prevents the tears from being able to drain through the system normally. This causes discharge from the eye and excessive tearing.

Pseudostrabismus
What is pseudostrabismus? Pseudostrabismus is when the eyes appear to be misaligned but are not truly misaligned. The eyes may appear to be crossed secondary to the shape of the eyelids and/or the bridge of the nose. Some children may have both pseudostrabismus and a true strabismus. Any child suspected of having misalignment of the eyes should be examined by a pediatric ophthalmologist. Your pediatric ophthalmologist will be able to properly diagnose your child’s condition.

Refractive Error
The eye has an opening in the front (pupil), a focusing crystalline lens inside the eye, and a light-sensing part in the back (the retina). This system works like a camera to focus incoming light rays properly on the retina so that the eye can have clear vision. If the light rays are not focused properly on the retina and come to a focus in front of or behind the retina, a refractive error (need for glasses) is present. There are three different types of refractive errors: myopia, hyperopia, and astigmatism.

Strabismus
What is strabismus? Strabismus is a condition in which the eyes are not aligned properly together and they point in different directions. Strabismus is most commonly names for the direction of the eye misalignment; common types include esotropia, exotropia, hypotropia, and hypertropia. Strabismus may also be named by its cause, for example, a third cranial nerve palsy, a sixth cranial nerve palsy, or a superior oblique palsy. Some special types of strabismus have unique names like Brown syndrome and Duane syndrome. Strabismus is usually caused by an abnormality of the neuromuscular (brain and muscle) control of eye movements. Sometimes a problem with the actual eye muscle(s) causes strabismus. Strabismus can occur in children who are otherwise developmentally healthy. Disorders that affect the brain, such as cerebral palsy, Down syndrome, hydrocephalus, and brain tumor are more likely to develop strabismus.

One eye may look straight ahead while the other eye turns up, down, in, or out. The misaligned eye can switch from one eye to the other. In order for the visual system to function properly, both eyes must point straight ahead at the same spot. This enables a person’s brain to recognize the images it sees and permits good vision. If the eyes are not aligned due to strabismus during childhood, the misaligned eye may have weaker vision than the straight eye. This secondary condition that may develop is called amblyopia.

In order for the eyes to be aligned and focus together, all muscles in both eyes must be balanced and working together.
What is the treatment for strabismus?
There are many different types of treatment for strabismus. The type of treatment depends on the type of strabismus and the patient’s history. The goal of treatment is to improve the eye alignment in order to enable the eyes to work together. Treatment may involve eye glasses or contact lenses, eye exercises, prisms, and/or eye muscle surgery.